Fazli Yanik

Sentinel lymph node mapping in patients with operable non-small cell lung cancer

BACKGROUND The aim of this study was to determine the accuracy and the role of the sentinel lymph node (SLN) in patients with non-small cell lung cancer. MATERIAL AND METHOD This study was carried out on 25 consecutive patients [M/F=23(:)2, mean age 62.84 (47-81) years] with operable non-small cell lung cancer (NSCLC). At thoracotomy, 0.25 mCi of Technecium(99m) (99mTc) nanocolloid was injected into each quadrant of lung tissue surrounding the tumor. Before resection scintigraphic measurements of lymph nodes were obtained in vivo and ex vivo using a hand-held gamma probe counter and the findings were compared with histological examination. SLN was defined as the node with the highest count rate. RESULTS SLNs were identified in 23 of 25 patients (92%) with a total number of 52 SLNs. Seven of 52 (13%) of these SLNs were positive for metastatic involvement after histological and immunohistochemical examination. In two patients (8%), SLNs could not be found. The sensitivity and specificity were 55% and 86% respectively. CONCLUSIONS This technic is a good method for identifying the first site of potential nodal metastases of NSCLC. These preliminary results demonstrate this procedure is feasible, but the detection rate has to be improved.

Massive Bochdalek diaphragmatic hernia in adult with hypoplastic lung

Bochdalek diaphragmatic hernia is generally congenital and rarely diagnosed incidentally in adults. A 21-year-old man presented with a diaphragmatic hernia suspected during routine examination. Chest radiography showed the colon and small intestine herniating into the left hemithorax and the ileocecal appendix in the superior thoracic apertura. We performed a thoracoabdominal incision and the stomach, omentum, colon, and small intestine were retracted back into the abdomen. The diaphragm was repaired with Prolene mesh following adhesiolysis. Two months later, there was no recurrence but no lung expansion. The space was filled with effusion, but the patient had no complaints.

Intrathoracic Desmoplastic Fibroblastoma: A Rare Localization

DOI: 10.4328/JCAM.603 Received: 03.02.2011 Accepted:18.02.2011 Printed: 01.01.2013 J Clin Anal Med 2013;4(1): 56-7 Corresponding Author: Yekta Altemur Karamustafaoglu, Trakya Universitesi Tip Fakultesi, Gogus Cerrahi AD, Kat:4, Balkan yerleskesi, 22030, Edirne, Turkey. T./F.: +9

A rare mediastinal occurrence of neuroblastoma in an adult: case report

CONTEXT Neuroblastoma is the most common extracranial malignant solid tumor that occurs during childhood. It arises from primitive cells and is seen in the adrenal medulla and sympathetic ganglia of the sympathetic nervous system. CASE REPORT We present a rare case of a 40-year-old man who was diagnosed with the onset of neuroblastoma arising in the mediastinum. He was treated by means of surgical resection in the superior mediastinum after neoadjuvant chemotherapy. The patients surgical outcome was satisfactory. CONCLUSION There are still no standard treatment guidelines for adult neuroblastoma patients. Although they have a poor prognosis, the main treatment option should be complete surgery at an early stage. This situation may become clarified through biological and genetic studies in the future.

Successful Implantation and Reconstruction of Chest Wall Invasion of Invasive Ductal Carcinoma of Breast

Breast cancer(BC) is described as a malignant development that occurs in the structure of the mammary gland. BC is the most common cancer in women. It is the major causes of death from cancer. We present a 62-years-old femalepatient had left radical mastectomy + axillary lymphnode curettage with a diagnosis of stage IIIA invasive ductal breast cancer 10 years ago. After adjuvant oncological treatment recurrence was detected in the chest wall. She successful operated with hybrid reconstruction using both synthetic and autologous grafts.

A rare cause of cough: An unnoticed broken metallic stylet in trachea

A 55-year-old woman, who had undergone coronary artery bypass surgery 20 days earlier was admitted with persistent cough. A broken stylet in the bronchus was not noticed on serial chest x-ray films until a metallic substance was expectorated by the patient. After admission to our clinic a chest roentgenogram and chest computed tomography showed a metallic foreign body in the trachea and right main bronchus ( Fig. 1a, b). A broken metallic stylet used for endotracheal tube insertion was successfully removed with rigid bronchoscopy (Fig. 2). Complications related to a broken stylet during endotracheal intubation have been rarely reported, and generally all incidents were detected immediately [1–3], unlike in our case. Disposable plastic covered stylets are recommended but in many developing countries, metal stylets are still commonly in use. Broken stylets should be recognized by symptoms and chest radiography. Careful examination of bone metallic stylet after intubation or the use of a plastic coated stylet are recommended to avoid this complication.