Gültekin Kaner

The correlation of angiogenesis with metastasis in primary cutaneous melanoma: a comparative analysis of microvessel density, expression of vascular endothelial growth factor and basic fibroblastic growth factor

Aim: To establish whether there is a correlation between angiogenesis and metastasis in primary cutaneous melanoma (PCMM). Methods: We studied the microvessel density and the expression of vascular endothelial growth factor (VEGF) and basic fibroblastic growth factor (bFGF) in 22 cases of PCMM with metastasis at presentation (metastatic group) and 28 cases of PCMM without metastasis for 24 months or more (non‐metastatic group). Microvessels were stained with CD31/PECAM‐1 antibody and counted. We assessed the proportion of VEGF expression in tumour cells, lymphocytes infiltrating the tumour (TIL) and lymphocytes at the periphery of the tumour, as well as the proportion of bFGF expression in tumour cell cytoplasms, nuclei and intra‐ and peritumoral vessels. Results: An increased microvessel density was detected in the metastatic group (15–33 [24.09±5.55] versus 2–24 [12.96±6.02]). Moreover, enhanced expression of VEGF in tumour cells and peritumoral lymphocytes (Chi‐square p = 0.038 and p = 0.018) and bFGF in peritumoral vessels (&khgr;2p = 0.013) correlated with the simultaneous presence of melanoma metastasis in PCMM. Furthermore, microvessel density was correlated with the expression of bFGF in peritumoral vessels (rs = 0.53, p = 0.049) and VEGF in tumour cells (rs = 0.37, p = 0.019). Conclusion: Microvessel density as well as the expression of both VEGF and bFGF might be informative concerning the progression of melanoma.

Retinoblastoma in Turkey: survival and clinical characteristics 1981 - 2004

Background: In this study, the authors aim to describe the survival and clinical characteristics of 141 retinoblastoma cases treated at Cerrahpasa Medical Faculty, University of Istanbul, Istanbul, Turkey, between 1981 and 2004.

Subconjunctival cyst extending into the orbit.

A fourteen year old girl who had developed a large subconjunctival mass extending into the orbit is presented. The mass had appeared after a strabismus operation, and it caused a consecutive exotropia and decreased adduction in the affected eye. She had had this cyst for six years. A cranial CT scan confirmed the presence of a massive orbital cyst. This cyst was removed surgically. Postoperatively, exotropia and adduction limitation improved. The pathological report stated that it was an epithelial cyst. This cyst and its differential diagnosis is the subject of this paper.

Kaposi Sarcoma Related to an Ectopic Hypothalamic Adrenocorticotropic Hormone-Secreting Adenoma: Case Report

OBJECTIVE We aim to report a case of Kaposi sarcoma (KS) with Cushings syndrome caused by endogenic glucocorticoid-induced immunosuppression. CLINICAL PRESENTATION A 43-year-old woman presented with delirium, hirsutism, fatigue, and hypertension. At the time of presentation, physical findings showed a Cushingoid appearance, with moon-like facies, hirsutism, and hyperpigmentation. Laboratory findings showed the following: adrenocorticotropic hormone, 86.7 pg/mL (normal range, 0–46 pg/mL); baseline cortisol level, 50 μg/dL (normal range, 6.2–19 μg/dL); potassium, 2.2 mEq/L (normal range, 3.5–5 mEq/L); and midnight cortisol level, 33 μg/dL. Serum cortisol levels failed to suppress after low and high doses of dexamethasone; these findings confirmed the diagnosis of ectopic adrenocorticotropic hormone production. Magnetic resonance imaging revealed a 12 × 15-mm, round, hypothalamic mass lesion in the center of the median eminence. INTERVENTION Endoscopic biopsy from the floor of the third ventricle was performed, and pathological examination of the lesion showed a diffuse adrenocorticotropic hormone-secreting adenoma. The patient developed diffuse skin lesions that were proven to be a KS by skin biopsy while she was prepared for transcranial surgery. After surgical removal of the adenoma, she became hypocortisolemic and required cortisol replacement. Within 1 month after surgery, all KS lesions disappeared spontaneously. CONCLUSION Excessive cortisol may induce immunosuppression. KS is one of the most common malignant tumors of patients with immunosuppression. To the best of our knowledge, this is the first case of Cushings syndrome with KS caused by endogenous glucocorticoid-induced immunosuppression.

A dark strain in the Fusarium solani species complex isolated from primary subcutaneous sporotrichioid lesions associated with traumatic inoculation via a rose bush thorn.

Fusarium species are hyaline hyphomycetes widely distributed in nature and documented agents of both superficial and systemic infections in humans. In this paper, we report a darkly-pigmented and initially non-sporulating isolate in the Fusarium solani species complex (FSSC) causing a post-traumatic sporotrichoid infection in an otherwise healthy, male patient. Sequencing of multiple loci showed that the isolate represented an otherwise unknown lineage, possibly corresponding to a separate species, within the multi-species F. solani complex. In prolonged culture, the non-sporulating isolate produced revertant wild-type subcultures with typical Fusarium conidiation. This suggests that the original dense, dark, non-sporulating isolate was a host-adapted form selected in vivo for characters compatible with human pathogenicity. The production of such forms by Fusarium species is increasingly recognized now that sequencing has allowed the identification of highly atypical isolates. In vitro antifungal susceptibility of the isolate was investigated against seven conventional and two newly approved antifungal agents. The isolate showed in vitro resistance to amphotericin B, but appeared susceptible to itraconazole and terbinafine. A cure was ultimately achieved with combined terbinafine/itraconazole therapy with prolonged itraconazole follow-up therapy.

Gözde kitle nedeni ile başvuran hastalarımızın geriye dönük olarak dökümü: 1985 2004 Retrospective analysis of patients admitted to our clinic with eye mass: 1985 2004 Orijinal Araştırma

Objective: The objective of this study is to analyse the patients with eye mass who were admitted to our clinic in a period of 20 years to classify both benign and malignant orbital or ocular tumors and to inform the pediatricians about the outcome of our analysis Material and Method: The records of 315 patients applied or referred to our pediatric hematology oncology department with eye mass between January1985 and December 2004 were reviewed The sex distribution the involvement site and the age at dignosis were analysed Results: 156 49 5 patients were males while 159 50 5 were females 151 of the masses involved the left eye 47 9 while 147 of them 46 7 were at the right side and 17 5 4 involved both eyes The age at diagnosis range ed between 1 and 192 months The median age at diagnosis was 25 months 282 89 6 of the cases had orbital tumors 22 6 9 cases had ocular surface tumors and 11 3 5 had intraocular tumors Conclusions: Pediatricians should notice the signs and symptoms of pediatric ocular and orbital tumors while examining their patients We would like to emphasize the importance of noticing the signs and symptoms of pediatric ocular and orbital tumors and vitality of referring patients to ophtalmologist in time Key words: child eye mass orbital

Cerrahpaşa Tıp Fakültesi Retinoblastom deneyimi Orijinal Araştırma

Aim: In this study we aim to describe the survival and clinical characteristics of 141 retinoblastoma cases treated at Cerrahpasa Medical Faculty University of Istanbul between 1981 and 2004 Material and Method: We retrospectively analyzed the clinical recordos of 141 children 177 eyes nbsp; diagnosed with retinoblastoma and treated between 1981 2004 The survival rates were calculated by Kapla meier method Results: One hundred and five 74 5 cases were unilateral and 36 25 5 were bilateral The overall mean age at the time of diagnosis was 25 months; in unilateral cases 29 months; and in bilateral cases 16 months The most common presenting signs were leukocoria 116 cases 82 strabismus 14 cases 10 and proptosis 11 cases 8 Conclusions: The three year cumulative survival rate of the 141 patients was 89 68 unilateral 90 74 ; bilateral 87 35 p=0 9371 p gt;0 05 log rank test Key words: Prognosis retinoblastoma survival

Acquired smooth muscle hamartoma

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Malignant proliferating tricholemmal tumor: report of three cases

Abstract We report three cases of malignant proliferating tricholemmal tumors, two of which displayed rapid growth of long-standing scalp nodules. The third case was a nodule on the scapula with axillary lymph node metastasis. Although some investigators believe that the diagnosis of malignancy is certain only with evidence of metastasis; in our first two cases morphologic features suggested malignancy which included infiltration of adjacent tissues, high degree of cytologic atypia, abundant dyskeratotic cells, monstrous multinucleated cells and atypical mitotic figures. We emphasize the possibility of malignancy in long-standing proliferating tricholemmal tumors that show rapid enlargement.

Surgical treatment of acne scarring by using skin grating knife

SummaryA method of dermaplaning for acne scarring using a skin graft knife is described. This surgical technique cannot be considered as a form of dermabrasion. Its advantages are reported.