Ali Fuat Çiçek

Is testis-sparing surgery safe in small testicular masses? Results of a multicentre study

INTRODUCTION Our goal was to evaluate benign and malignant lesions and testicular intraepithelial neoplasia (TIN) in the neighbouring normal-appearing testis tissue in men who underwent radical orchiectomy for testicular mass with a pathologic tumour size of ≤3cm. METHODS In this retrospective, multicentre study, data of 252 patients from 11 different institutions were included. Patients were divided into three groups based on tumour size: Group 1 (0-1 cm; n=35), Group 2 (1.1-2cm; n=99), and Group 3 (2.1-3 cm; n=118). Benign lesions and TIN were sought in the neighbouring testicular tissue and compared between groups. RESULTS Mean patient age was 32.3 years. Benign lesions were reported in 54.3%, 33.3%, and 14.4% of Groups 1, 2, and 3, respectively (p<0.05 between groups). TIN was detected in 20%, 42.4%, and 41.5% of Groups 1, 2, and 3, respectively (p<0.05 for Group 1 vs. Groups 2 and 3; p>0.05 for Groups 2 vs. 3). Multifocality was detected in 8.6%, 4%, and 0% of Groups 1, 2, and 3, respectively (p<0.05 for both Group 1 vs. Group 3 and for Group 2 vs. Group 3; p>0.05 for Group 1 vs. Group 2). A tumour cutoff size of 1.5 cm was found to be significant for detecting benign tumour. TIN and multifocality rates were similar in patients with a tumour size of ≤1.5 vs. >1.5 cm (p>0.05). CONCLUSIONS Benign lesions and TIN in the neighbouring testis were significantly decreased and multifocality was increased in patients with a tumour mass size of ≤1 cm. Testis-sparing surgery should be performed with caution and a safety rim of normal tissue should also be excised.

Case report of a rare dermatosis in pregnancy: Impetigo herpetiformis

Impetigo herpetiformis (IH) is a very rare type of dermatosis seen in pregnancy. According to the published work, IH during pregnancy is associated with the risk of stillbirth, and obstetric management in such cases is very important. Early recognition is important to reduce both maternal and fetal morbidity. We present a case of IH resistant to corticosteroid therapy in a 27‐year‐old pregnant woman where the pregnancy was terminated by the induction of labor.

Nevus sebaceus with basal cell carcinoma, poroma, and verruca vulgaris

Nevus sebaceus (NS) is a congenital, benign, hamartomatous lesion and it is possible to see several benign or malignant tumors accompanying it. One of these is the poroma, which is very rare, and has only been reported twice before, in the English literature. In this paper, we presented two new cases of NS. One of them was a 40-year-old male who presented with a congenital skin lesion on his temporoparietal region. This lesion was composed of four different lesions, including NS, poroma, basal cell carcinoma (BCC), and verruca vulgaris. The second patient was a 41-year-old male presenting with a yellow-brown patch on the scalp. This lesion was comprised of NS and BCC. In addition to these presentations, we discussed the differential diagnosis between BCC and trichoblastoma, both of which are likely to be seen with NS. For this purpose, we recommended an immunohistological panel, which may be useful for differentiating these two morphologically similar lesions.

Is there any superiority among diagnostic methods in organizing pneumonia in terms of clinical features of the patients

Background Organizing pneumonia (OP) can be idiopathic or secondary to some clinical situations. If an etiological cause is not present, this phenomenon is called cryptogenic OP. Secondary OP is associated with various diseases that are known to induce the OP. Objectives The aim of this study was to evaluate the clinical features of the cases with OP and compare the patients diagnosed by bronchoscopic transbronchial biopsy with patients diagnosed by surgical lung biopsy. Patients and methods Medical records of 41 patients diagnosed with OP between 2004 and 2014 were reviewed retrospectively. Results Totally, 41 patients with OP were identified. In all, 39.02% of the cases were diagnosed by bronchoscopic methods, and 60.97% of the cases were diagnosed by surgical procedures. Although the frequency of ground glass opacities, consolidations, and micronodules was higher in the group diagnosed by bronchoscopy, mass-like lesions were more common in the cases diagnosed by surgery. Bronchoscopy, performed in 30 patients totally, had a diagnostic efficacy of 53.33%. Diagnostic value of bronchoscopy was significantly higher in cryptogenic OPs. Although diffuse radiological pattern was more common in “successful bronchoscopy” group, frequency of focal pattern was higher in “failed bronchoscopy” group. Ground glass opacity in successful bronchoscopy group and mass-like lesions in failed bronchoscopy group reached significant differences. Conclusion There were significant differences between the diagnostic procedures in terms of radiological patterns. This is the first study about the relationship between the diagnostic methods and the characteristics of OP.

Hemangioma of the Zygomatic Bone.

Benign masses arising from facial bones have been reported several times in the literature. Hemangiomas are one of the uncommon benign tumors. In this study, the authors aimed to present a rare patient of zygomatic intraosseos hemangioma and their management. A 40-year-old woman with a mass in her left lateral cantus admitted to our clinic. Preoperative computed tomography and magnetic resonance imaging revealed an osseos mass in her left zygoma. The authors conclude that it should be kept in mind that although they are very rare benign tumors, intraosseos hemangiomas can cause facial masses. Meticulous radiologic examination can give important clues for differential diagnosis before the surgery.

Ovarian malignancy incidentally diagnosed during caesarean section

Overin musinoz tumorleri, seroz over tumorlerinden sonra en sik karsimizi cikan epitelyal over tumorlerindendir. Gebelik esnasinda over tumorleri ile nadir olarak karsilasmaktayiz. Olgularin bir kismi, rutin antenatal takipler sirasinda ultrasonografi ve fizik muayene ile tani alirken, diger bir kismi ise insidental olarak sezaryen sirasinda karsimiza cikmaktadir. Bu olguda, 30 yasinda nullipar hastada, sezaryen ile dogumu gerceklestirildigi esnada insidental olarak tespit edilen over tumorunden soz edilmistir.

Hereditary leiomyomatosis and renal cell carcinoma syndrome: a case report and implications of early onset

Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) is an autosomal dominant manifestation of cutaneous and uterine leiomyomas together with renal cancer due to autosomal dominant germline mutations of fumarate hydratase gene. A twenty-year-old female patient presented with type-II segmental piloleiomyoma and increased menstruation due to uterine leiomyomas, with a history of bilateral nephrectomy performed at 13 and 16 years of age for type 2 papillary renal cell carcinoma. This case represents one of the very early onsets of hereditary leiomyomatosis and renal cell carcinoma syndrome. As genetic anticipation for renal cancer is a well-documented entity for HLRCC syndrome, early recognition is crucial for both the patient and her family in order to provide appropriate counseling and initiation of surveillance.