Biomedical subjects

T Küçükali

Publications and source records attributed to T Küçükali.

At least 19 recordsLinked to original sources

PubMed2005

High-grade neuroendocrine carcinoma of the cervix. A case report.

Neuroendocrine tumor of the uterine cervix is a rare and aggressive malignancy. Despite controversial, multimodal treatment methods, prognosis and treatment outcomes are worst in advanced stages. We report an early-stage case treated with the multimodal approach. The nomenclature proposed for this tumor type in 1997 by the College of American Pathologists still has some points of discussion. As in our case some of the tumors cannot be defined exactly into small or large cell types, and this causes confusion at least for nomenclature purposes. A 'mixed' type for this tumor may be appropriate.

Adult↗

PubMed2004

Fibrocystic disease of vulvar ectopic breast tissue. Case report and review of the literature.

INTRODUCTION: Mammary glands located in the vulvar region have been named as ectopic breast tissue or anogenital mammary glands by different authors. Literature on pathologies of ectopic breast tissue located in the vulvar region is rare. Most of the reports are about the malignancies arising from this ectopic tissue. CASE REPORT: We report a case of fibrocystic disease of the mammary glands in the vulva in a 25-year-old pregnant woman. Her disease was exaggerated during pregnancy. CONCLUSION: Ectopic breast tissue in the vulva is a rare entity and fibrocystic disease of this tissue has rarely been reported in the English literature.

Adult↗

PubMed2000

Fibroadenoma of the vulva.

A well-circumscribed mass was excised from the vulva of a 37-year-old woman. Histological and immunohistochemical findings showed the characteristic features of fibroadenoma of breast. The concepts about the histogenesis of this lesion were discussed.

Adult↗

PubMed2000

Disseminated peritoneal leiomyomatosis. A benign entity mimicking carcinomatosis.

Disseminated peritoneal leiomyomatosis (DPL) is a rare entity, occurring primarily in premenopausal women. The lesion is characterized by numerous subperitoneal nodules of benign smooth muscle proliferations which usually mimics the macroscopic appearance of the peritoneal carcinomatosis. We report a case of DPL and multiple uterine leiomyomas, occurring in a 50 year old premenopausal woman who was on oral contraceptives for the last three years. In order to diagnose this entity clinicians and pathologists have to be alert and collaborative during the intraoperative frozen section consultation.

Carcinoma↗

PubMed2000

A case of late infantile neuronal ceroid lipofuscinosis associated with precocious puberty.

Neuronal ceroid lipofuscinosis is one of the hereoffegenerative diseases for which clinical and neuropathologic findings are well documented. We present a patient with late infantile neuronal ceroid lipofuscinosis with true precocious puberty; to our knowledge, this association has not been reported before. The association could be due to an underlying disturbance of hypothalamic-pituitary gonadal function, or to coincidence.

Atrophy↗

PubMed1998

Laryngeal pleomorphic rhabdomyosarcoma.

A case of an extremely unusual tumor of the larynx, pleomorphic rhabdomyosarcoma, is presented with a review of literature. This is the fifth case of this malignancy described in the larynx in the English language literature. A histopathological diagnosis was made with immunohistochemistry and electron microscopy. In contrast to other reported cases, the tumor in the present case had a very aggressive behavior. Despite radical surgery involving total laryngectomy and neck dissection followed by radiation therapy, the patient died of disease 8 months following treatment.

Aged↗

PubMed1998

Mucin production in carcinomas of the uterine cervix.

The histological types of the cervical carcinoma effect the incidence, prognosis and the treatment methods. One hundred and eighty-seven cases selected randomly among the cervical carcinoma were stained with mucicarmen, alcian blue, PAS, and PAS with diastase to identify the presence of intracellular mucin. One hundred and seventy-two squamous carcinoma were examined and 27.3% (47 cases) of them were shown to contain some degree intracellular mucin (nine cases which were originally diagnosed squamous carcinoma after the application of mucin stains to the tumors, reclassified as adenosquamous carcinoma because of demonstrated widespread intracellular mucus). Of the 14 adenocarcinomas, 13 were mucin positive. Mucin-positive tumors (independent of histological type) had metastasized to the lymph nodes in 23 of 60 cases (38.3%), in contrast to mucin-negative tumors which had metastasized in 24 of 127 cases (18.9%). The application of mucin stains can assist in the classification of poorly differentiated lesions as well as help in the planning of management and in the prognosis.

Adenocarcinoma↗

PubMed1998

The value of intraoperative consultation (frozen section) in the diagnosis of ovarian neoplasms.

BACKGROUND: Frozen Section is an important diagnostic tool to determine the nature of ovarian masses. However, like other diagnostic tools, frozen section also has some pitfalls. We aimed to discuss the source and the nature of inaccuracies associated with this procedure. METHODS: In this retrospective study 360 cases of ovarian masses examined by frozen section were re-evaluated. The sensitivity, specificity and predictive values of frozen section diagnosis of ovarian tumors were calculated. The reasons for the erroneous frozen-section diagnoses were discussed. RESULTS: Overall diagnostic agreement for ovarian lesions was 94.2%. Disagreements were found in nine cases (2.5%). Diagnosis was deferred to permanent sections in 12 cases (3.3%). The sensitivity for malignant tumors was 93.1% and specificity was 99.2%. The sensitivity for benign tumors was 99.2% and specificity was 92.1%. Most problematic cases were mucinous tumors, followed by tumors resembling fibrothecomas, in addition sections without viable tissue fragments or presence of extensive hemorrhage and necrosis also obscured the frozen diagnosis. Another factor was the lack of an effective communication between the surgeon and the pathologist. CONCLUSIONS: For an effective usage of this method not only the pathologist but also the surgeons must know the pitfalls of this method and also there must be good communication between the pathologist and the surgeon. Especially deferred cases should be minimized by good communication. In fact it's an intraoperative consultation method that enables the pathologist to gather all the preoperative, intraoperative findings and to be familiar with the further treatment plan of the patient.

Female↗

PubMed1998

Skinning vulvectomy for the treatment of vulvar intraepithelial neoplasia 2-3: a study of 21 cases.

Twenty-one cases of patients with vulvar intraepithelial neoplasia (VIN) 2-3 were reviewed. The mean age at diagnosis was 45.4 years. All of the patients presented with vulvar pruritus. Five of the patients had hypertension, two had coronary heart disease and two had diabetes mellitus as complicating medical illnesses. None of the patients had history or evidence of vaginal intraepithelial neoplasia (VAIN) or cervical intraepithelial neoplasia (CIN), and only one patient had invasive cervical cancer at diagnosis. Provided the histology confirmed VIN, the patients were subjected to a skinning vulvectomy procedure. Of the patients, 15 (71.4%) had VIN 2, and the remaining 6 (28.6%) had VIN 3 at preoperative evaluation. Histologic analysis of skinning vulvectomy specimens revealed no evidence of neoplasia in three patients (14.2%). Multifocality was observed in only three patients (14.2%). The areas involved were the perineum in four patients, labia in 15 and clitoris in two patients. Associated vulvar pathologies were condyloma acuminata in one, squamous vulvar hyperplasia in three and lichen sclerosus with squamous hyperplasia in one patient. The complications of the procedure included febrile morbidity in three patients and minor wound break-down in one patient. None of the patients in this series experienced recurrence. Skinning vulvectomy seems to have a high success rate in treatment of VIN 2-3 with minimal postoperative complications and satisfactory cosmetic results. However, observation of only three patients with multifocal lesions as well as no patient with invasive cancer adds credence to an ablative procedure after appropriate evaluation under colposcopy.

Adult↗

PubMed1997

Primary neuroendocrine tumor of the breast.

Adult neuroendocrine tumors may present with a wide range of clinical symptoms that share specific ultrastructural and biochemical features. A 63-year-old post-menopausal female patient was admitted to the hospital with a mass in her right breast and the diagnosis was primary neuroendocrine tumor of the breast. Although neuroendocrine tumors can originate in various parts of the body and breast carcinoma with neuroendocrine differentiation has been described, primary neuroendocrine tumor of the breast is very unusual. This case is now presented and the current literature is reviewed.

Breast Neoplasms↗

PubMed1997

Microinvasive carcinoma of the cervix: an analysis of 31 patients.

A retrospective analysis of 31 patients subjected to radical surgery and lyphadenectomy for microinvasive cervical cancer was carried out. The mean age of the patients at diagnosis was 51.4 years. Twenty-nine of the patients had depth of invasion of 3 mm or less whereas 5 of them had lymphovascular space invasion. Thus, 24 patients had microinvasive cervical cancer according to the SGO (Society of Gynecologic Oncology) criteria. While nine patients had minimal stromal invasion (< 1 mm) at diagnosis, the remaining 22 patients fulfilled the criteria of FIGO IA2 disease. Most of the patients had grade I disease. With worsening of differentiation lymphovascular space involvement increases from approximately 11% (2/18) to 50% (1/2). None of the patients had lymph node involvement. All patients are living with no evidence of disease with a mean survival of 39 months. Current FIGO criteria for microinvasive carcinoma permits us to define a subset of patients that can safely be subjected to a more conservative approach.

Female↗

PubMed1996

Primary carcinoid of the kidney.

A rare case of primary renal carcinoid tumour is presented. The diagnosis was based on immunohistochemically diffuse cytoplasmic positivity for chromogranin A and neuron-specific enolase, in addition to histologic findings. Only 14 previous cases of this tumour have been documented in the literature.

Adult↗

PubMed1996

Serous surface papillary carcinoma.

Three cases of serous surface papillary carcinoma of the abdominopelvic peritoneum are presented. All of the patients were subjected to a relatively homogeneous management consisting of primary surgery and cisplatin based chemotherapy regimen. The second look procedures of two patients were found to be negative. Although these tumors are known to have a poor prognosis, aggressive surgery and cisplatin based chemotherapy seem to have promising results.

Adult↗

PubMed1996

Squamous cell carcinoma arising in dermoid cyst.

Since malignant transformation in a dermoid cyst is extremely rare, the clinicopathological characteristics of patients with squamous carcinoma arising in dermoid cyst are evaluated in the hope of offering a more rational therapy. Our first patient was lost to follow-up after surgery. In the second patient, with a gross stage III disease, after extensive surgery and multiagent chemotherapy we were able to achieve a remission period of 42 months. In the third patient with pelvic lymph node metastases, adjuvant radiation and chemotherapy was administered following surgical staging. She was free of disease 6 months after surgery. Malignant transformation in a dermoid cyst is a rare complication observed especially in older age groups. Thus, a frozen section in these decades may improve detection of this complication allowing a more accurate staging. Although poor prognosis is reported, an aggressive approach with cisplatinum based chemotherapy and radiation and even with secondary cytoreduction, long-term remission may be achieved.

Carcinoma, Squamous Cell↗

PubMed1996

Predictors of persistent disease in women with complete hydatidiform mole.

OBJECTIVE: To determine the most significant factors for persistent disease in women with hydatidiform mole. STUDY DESIGN: Eighty-two patients who were managed consecutively without prophylactic chemotherapy between 1973 and 1993 were analyzed retrospectively for clinical and pathologic features, including age of the patient, size of the uterus, human chorionic gonadotropin (hCG) level, presence of theca lutein cysts, evidence of preeclampsia or hyperthyroidism, history of hydatidiform moles, trophoblastic hyperplasia, nuclear atypia, necrosis and hemorrhage, trophoblastic maturation, presence of fibrinoid layer and ratio of cytotrophoblast to syncytial trophoblast. RESULTS: Thirty-one patients developed persistent trophoblastic neoplasia (38%). Of the parameters evaluated, elevated hCG level, advanced age, history of hydatidiform mole, presence of hyperplasia, marked nuclear atypia and necrosis, and hemorrhage were significant risk factors for persistent neoplasia after univariate analysis. Among the factors analyzed, trophoblastic hyperplasia (relative ration [RR] = 3.56), age (RR = 2.87) and history of mole (RR = 2.57) were identified as the most powerful indicators of persistent disease after multivariate analysis. CONCLUSION: Evaluation of the clinical and pathologic features, such as age, history of mole and presence of trophoblastic proliferation may aid in defining a subset of patients at high risk for persistent disease, who require closer follow-up and administration of prophylactic chemotherapy.

Adolescent↗

PubMed1995

Tumor status of lymph nodes in early endometrial cancer in relation to lymph node size.

A retrospective analysis of 36 patients with metastatic nodes out of 209 consecutively managed patients with a clinically stage I endometrial cancer was carried out. Of the 1023 lymph nodes removed, 154 nodes were found to be metastatic. The mean number of the involved nodes was 4.27 (range: 1-29). Of the 154 positive nodes, 3 had nodal diameters < or = 3 mm (1.9%), 84 had diameters of 4-10 mm (54.6%), 60 had diameters of 11-20 mm (39.0%) and 7 had diameters more than 20 mm (4.5%). With increasing lymph node size, the frequency of tumoral involvement varies from 1.0% in nodes < or = 3 mm to 63.6% in nodes bigger than 20 mm. In terms of patients, nine of them were found to have a single metastatic node ranging from 6 mm to 10 mm in diameter. In the remaining 27 patients with multiple metastatic nodes, the biggest nodes encountered were 6-10 mm in 4 (14.8%), 11-20 mm in 17 (62.9%) and more than 20 mm in 6 (22.2%) patients. Since mere sampling of the lymphatic tissue directed particularly to the enlarged nodes may not show the true incidence of positive nodes, a complete lymphadenectomy is advocated in order to obviate an understaging problem.

Endometrial Neoplasms↗

PubMed1995

Malignant germ cell tumors of the ovary: Hacettepe hospital experience.

BACKGROUND: To determine the most important prognostic factors in patients with malignant germ cell tumors of the ovary. METHODS: Age, histologic type, tumor size, stage, treatment mode, type of surgery of 67 patients with malignant germ cell tumors managed consecutively were evaluated retrospectively using multivariate analysis. RESULTS: The overall survival rate was 60.6%. This figure was 78.5% for dysgerminoma, 53.3% for immature teratoma, 12.0% for endodermal sinus tumor, 33.3% for mixed germ cell tumor and 100.0% for others. The patients with endodermal sinus tumor had significantly poorer survival than other groups. Among the factors analyzed for survival histologic type was found to be the most significant predictor for survival. CONCLUSIONS: Finding of histologic type as the strongest independent risk factor may be evaluated in correlation with the literature that these tumors have historically been investigated as dysgerminomatous and nondysgerminomatous tumors. Furthermore, endodermal sinus tumors had long been known for poor survival. Based on this data, despite advent of staging and effective chemotherapy, prognosis still is basically related to histologic type and histology of tumor should be taken into account while comparing results.

Adult↗

PubMed1994

Risk factors for recurrence in clinically early endometrial carcinoma: an analysis of 183 consecutive cases.

This study includes 183 patients with clinical stage I endometrial carcinoma. All patients had standard surgical staging procedure including peritoneal cytology, total abdominal hysterectomy, bilateral pelvic and paraaortic lymphadenectomy. The factors analysed for recurrence were age, menopausal state, cell type, grade, mitotic activity, myometrial invasion, lymphovascular space invasion, cervical involvement, microscopic vaginal metastases, adnexal metastases, peritoneal cytology, concomitant endometrial hyperplasia and pelvic and paraaortic node metastases. The overall recurrence rate was 14.2% (26/183). Of the 26 patients with recurrence, 11 had local and 13 had distant metastases. In the remaining two patients (7.7%), both local and pelvic metastases were observed. Of the factors analysed, age, grade, mitotic activity, myometrial invasion, lymphovascular space invasion, microscopic vaginal metastases, adnexal involvement and pelvic and paraaortic nodal metastases were found to be significant predictors of recurrence. After multivariate analysis, advanced age (RR = 1.05), marked mitotic activity (RR = 3.11), pelvic and/or paraaortic nodal metastases (RR = 6.37) were chosen as the most important determinants of recurrence. In terms of surgical pathological stages, recurrence risk reaches up to 45.4% for stage IIIC disease. Using surgical pathological parameters, it is possible to predict recurrence but because of high rate of distant failures it still seems hard to improve survival of this group. Detection of a substantial risk of recurrence even in stage IA/B grade 1 group warrants adjuvant therapy in all patients after primary surgery.

Age Factors↗