Dogan Vatansever

Clinicopathologic and survival analyses of synchronous primary endometrial and epithelial ovarian cancers

The aim of the study was to describe clinicopathologic characteristics, survival outcomes and the factors associated with recurrence in patients diagnosed with synchronous primary endometrial and epithelial ovarian cancers.

Combination of adjuvant chemotherapy and radiotherapy is associated with improved survival at early stage type II endometrial cancer and carcinosarcoma

The aim of this study was to describe the impact of postoperative adjuvant treatment modalities and identify risk factors associated with recurrence and survival rates in women diagnosed with early stage type II endometrial cancer and carcinosarcoma.

Extrapulmonary lymphangioleiomyomatosis mimicking lymphoma metastatic to uterus

Lymphangioleiomyomatosis is a very rare disease that primarily affects the lungs. The atypical smooth muscle cells in these tumors stain both with smooth muscle markers and melanocytic markers characteristically like their counterparts in other members of the PEComa family. Extrapulmonary lymphangioleiomyomatosis, especially without pulmonary involvement, is extremely rare. The clinical importance of lymphangioleiomyomatosis lies in the fact that it may mimic other malignant diseases, such as lymphoma or sarcoma. Here, we report a case of extrapulmonary lymphangioleiomyomatosis without involvement of the lungs, in a patient pre‐diagnosed as having lymphoma metastasized to the uterus or uterine sarcoma.

SERVİKAL OLGUNLAŞMA AMACI İLE UYGULANAN PROSTAGLANDİN E2 TEDAVİSİNDE BAŞARIYI BELİRLEYEN FAKTÖRLERİN DEĞERLENDİRİLMESİ

Amac: Dogum induksiyonunun endike oldugu hastalarda, servikal olgunlasma amaci ile uygulanan prostaglandin E2’nin basarisinda etkili olabilecek faktorleri ortaya koymak. Gerec ve Yontem: Calismaya fetal kardiyak aktivitesi (+), Bishop skoru 3’un altinda, bas prezentasyonu, reaktif nonstres testi (NST) olan ve aktif kontraksiyonu olmayan gebeler dahil edilmistir. Servikal olgunlastirma metodu olarak 10 mg dinoproston yavas salinimli ovul kullanildi. Servikal muayenede Bishop skoru 5’in uzerine cikan hastalar tedavinin basarili oldugu, 5 in altinda kalanlar ise tedavinin basarisiz oldugu grup olarak tanimlanmistir. Her iki grup arasinda yas, gravida, parite, vajinal pH, ilk kontraksiyonun ortaya cikma zamani, aktif kontraksiyonlarin ortaya cikma zamani, fetal agirlik, fetal karin cevresi (AC) ve biparietal cap (BPD) karsilastirildi ve bu faktorlerin servikal olgunlastirma metodu olarak uygulanan 10 mg dinoproston yavas salinimli ovulun basarisi uzerine etkili olup olmadigi arastirildi. Bulgular: Maternal yas, parite, son adet tarihi esas alinarak hesaplanan gebelik gunu, fetal BPD, AC olcumlerinin basariyi belirlemede etkin olmadigi (p:0.54; p:0.06; p:0.11; p:0.123; p:0.127) ancak gebelik sayisi, servikal dilatasyon, efasman, vaginal pH, ilk kontraksiyonun baslamasi icin gecen sure, etkin kontraksiyonlarin baslamasi icin gecen sure ve fetal agirligin basariyi belirlemede etkin oldugu gosterilmistir (p:0.017; p:0.021; p:0.007; p<0.01; p<0.01; p<0.01; p:0.046). Sonuc: 10 mg yavas salinimli dinoproston tedavisi oncesi obstetrik anamnez, fizik muayene ve ultrasonografik inceleme ile hastalarin tedaviye muhtemel yanitlari anlasilabilir. Gebelik sayisi yuksek olanlarda, servikal dilatasyon ve servikal efasmani fazla olanlarda, ilk ve etkin kontraksiyonlarin erken cikmasi halinde, vajen pH’si yuksek kisilerde, 10 mg yavas salinimli dinoproston vajinal ovul ile elde edilen basari artmaktadir. Anahtar kelimeler: Dogum; induksiyon; Prostaglandin E2; dinoporoston; serviks; olgunlasma.

MEGASİSTİS VE ARTMIŞ NUKAL TRANSLUSENSİ İLE PREZENTE OLAN TRİZOMİ 18: OLGU SUNUMU

Amac: Bu vaka sunumunun amaci erken gebelik haftasinda saptanan fetal megasistis ve artmis nukal translusensi ile birliktelik gosteren trizomi 18 olgusunu sunmaktir. Olgu: Hastanin birinci trimester ultrasonografik taramasinda fetal longitudinal mesane capi 19mm, nukal translusensi ise 5 mm olarak olculdu. Ductus venozus doppler incelemesinde patolojik ters “a” dalgasi tespit edildi. Hastaya 16. gebelik haftasinda amniosentez yapildi. Fetal karyotipleme sonucu trizomi 18 olarak saptandi. Gebelik ailenin de istegiyle sonlandirildi. Sonuc: Fetal megasistis ve artmis nukal translusensinin kromozom anomalileri ile birliktelik olasiligi yuksek oldugundan fetal karyotip tayini yapilmasi gerekliligini belirtmek istedik. Anahtar kelimeler: megasistis; trizomi 18; nukal kalinlik olcumu

Diaphragmatic resection preserving and repairing pericardium, splenectomy and distal pancreatectomy for ınterval debulkıng surgery of ovarıan cancer.

OBJECTIVE The majority of ovarian cancer patients are initially diagnosed at an advanced-stage [1]. Upper abdominal bulky metastasis cephalad to the greater omentum reported to be present in 42% of patients [2]. Many complex surgical procedures such as splenectomy, pancreatectomy, mobilization and partial resection of liver, porta hepatis dissection, diaphragmatic peritonectomy and resection are frequently performed to achieve complete resection of metastatic disease [3]. Our aim in this surgical film is to show the resection of a left sided diaphragmatic implant located beneath the heart, with dissection from the pericardium after entrance to the pericardial cavity. Additionally, step by step splenectomy with distal pancreatectomy also presented. METHODS A 67years-old woman referred to our clinic for interval debulking for advanced stage suboptimally debulked high grade serous ovarian carcinoma. The tumor invading distal pancreas, hilum and parenchyma of spleen is clearly seen on magnetic resonance imaging. Another implant was also visible on left side of the diaphragm. We achieved complete cytoreduction with no macroscopic disease at the end of the surgery. RESULTS She stayed at the intensive care unit for two days and in our clinic for seven days. We did not encounter any grade 3 or 4 adverse event in post-operative period. CONCLUSION The surgical treatment of ovarian cancer has evolved in time in favor of radical surgery. The surgical team should be highly motivated, skilled and experienced for this complex procedures, since being able to reach complete cytoreduction is the most important predictor of survival in ovarian cancer patients.

Efficacy of endocervical curettage and CA-125 measurement in endometrial serous carcinoma: A case series and literature review

Objective: This is a case series and literature review of patients with endometrial serous carcinoma (ESC) in which endocervical curettage (ECC) and CA-125 measurement were utilized as a diagnostic procedure in preoperative staging. Materials and Methods: The patients were treated in the gynecologic oncology clinic of İstanbul University Faculty of Medicine between January 2005, and January 2015. A total of 37 patients were included in the final analysis. Results: ECC accurately predicted ESC in 22 patients (59.5%). The mean pre-operative serum CA-125 level was 73.24±3.30 IU/mL; pre-operative serum CA-125 levels were elevated above 35 IU/mL in 25 patients (69%). Conclusion: ECC is an acceptable diagnostic tool to predict the presence or absence of cervical involvement in endometrial cancer. On the other hand, its accuracy in specific subgroups requires further analysis in carefully designed prospective studies. Furthermore, pre-operative serum CA-125 levels may be important for management and counseling in the subgroup of women with ESC.