Hasan Erol Eroğlu

The clinicopathological and prognostic significance of CD24, CD44, CD133, ALDH1 expressions in invasive ductal carcinoma of the breast: CD44/CD24 expression in breast cancer.

BACKGROUND Recently, there are several studies about cancer stem cells (CSC), indicating that they are the cells that initiate the tumor, provide progression, metastasis and responsible for the aggressive tumor behavior. MATERIALS AND METHODS The purpose of this study is to investigate the expressions of CD24, CD44, their different combinations, ALDH1 and CD133 in invasive ductal carcinoma. Their relationships with clinicopathologic parameters, such as tumor grade, lymphovascular invasion, tumor size, axillary lymph node involvement, stage, hormone receptors, HER2 expression, basal like tumors, triple negative status and prognosis were also investigated. Tissue microarray method was used to investigate ımmunohistochemical CD24, CD44, ALDH1 and CD133 expressions in 105 invasive ductal carcinoma cases. RESULTS CD133 expression was significantly associated with tumor size (p=0.023) and stage (p=0.009). CD133 expression was decreased in tumors with larger tumor size, higher stage and lymphovascular invasion. CD133 expression was positively correlated with CD44 (r=0.212, p=0.032) and CD44(+)/CD24(+) (r=0.202, p=0.040) expressions. CD44, CD24 and ALDH1 expressions showed no significant relationship and correlation with clinicopathologic features. There was a significant relationship (p=0.048) between CD44(+)/CD24(-/low) phenotype and basal like tumors. EGFR expression was positively correlated with CD44(+)/CD24(-/low) phenotype (r=0.211, p=0.036). CONCLUSIONS Basal like tumors are enriched for CSCs with CD44(+)/CD24(-/low) phenotype. CD133 can detect a different population of CSC in breast carcinoma.

A rare breast tumors: Primary neuroendocrin carcinoma

Breast cancer is the most frequently seen cancer in females but primary neuroendocrine carcinoma of the breast, which was defined as a separate entity in the 2003 World Health Organisation tumour classification, is seen extremely rarely. This entity, which is still not well-defined and has not been well-researched, demonstrates a more aggressive course than invasive ductal carcinoma. As metastatic breast neuroendocrine tumours are more widespread and the treatment strategy is different, preoperative differential diagnosis is important. The basic diagnostic method is pathological examination. If a neuroendocrine pattern is determined in microscopy, then immunohistochemical study of neuroendocrine markers should be made. It is necessary to be vigilant in terms of synchronous tumours and metachronous tumours which may develop in the postoperative period as the incidence of synchronous and metachronous cancers in patients with neuroendocrine tumours is higher compared to the general population. The case presented here is of a 73-year old patient who presented with complaints of a breast lump, which was thought to be invasive breast cancer, and as a result of the operation with pathological and immunohistochemical examination, primary neuroendocrine carcinoma of the breast was determined. With more advanced evaluations, no synchronous or metachronous tumours were determined.

Evaluation of the association between HIF-1α and HER-2 expression, hormone receptor status, Ki-67 expression, histology and tumor FDG uptake in breast cancer

The present study aimed to examine hypoxia-inducible factor (HIF)-1α expression and its association with glucose uptake in invasive breast cancer. In addition, connections between glucose uptake and several other prognostic parameters of breast cancer were studied. Between August 2013 and April 2015, 92 patients with biopsy-diagnosed breast cancer were subjected to 18F-fluorodeoxyglucose positron emission tomography/computed tomography. The primary tumor and nodal maximum standardized uptake values (SUVmax) were recorded, and HIF-1α expression and clinical parameters, including tumor mass, estrogen receptor (ER) and progesterone receptor (PgR) levels, human epidermal growth factor receptor-2 (HER-2), Ki-67 index, grade and histology, were analyzed. SUVmax was compared with clinicopathological parameters and HIF-1α expression. The median SUVmax values of the ER-negative and PgR-negative tumors were significantly increased compared with ER and PgR-positive tumors, respectively (P=0.004 and P=0.008). SUVmax differed significantly between the T2 and T3 tumors and the T1 tumors. The median SUVmax levels were higher in the Ki-67 expression >10% group than the Ki-67 index <10% group (P=0.001). Although the median SUVmax values in HER-2-positive and -negative tumors were similar, triple-negative tumors demonstrated significantly higher values (P=0.04). With regard to tumor grade, the median SUVmax was greater in the high-grade tumors compared with the low-grade tumors. SUVmax did not exhibit a significant correlation with HIF-1α expression; however, HIF-1α expression was associated with tumor size and PgR expression. HIF-1α expression increased with a larger tumor size (r=0.27; P=0.008) and decreased PgR expression (r=−0.26; P=0.0002). The axillary nodal SUVmax of the N1 tumors was significantly lower than the N2 and N3 tumors (P<0.0001). In the multivariate analysis, tumor size, Ki-67 expression and ER Allred score were independent factors that impacted SUVmax. The results of the present study indicated strong associations between tumor size, tumor grade, Ki-67 expression, triple-negativity, downregulated hormone receptor expression and SUVmax values. Conversely, there was no association observed between glucose uptake and levels of HIF-1α. Based on these results, it is suggested that the lack of assiocation between hypoxia and glucose uptake indicates phenotypic independence.

A Urachal Cyst Case with Painful Mass Locates at Ileal Mesentery

Urachal cyst is an unusual clinical condition, which is usually asymptomatic. In some adult cases, it may lead to complications. The cyst is between umbilicus and urinary bladder. It is diagnosed via ultrasonography and computed tomography. However, in some cases, the diagnosis is made by means of surgical exploration and histopathological evaluation. In this paper, we report a case of a 17-year-old female presenting with painful abdominal mass. At the first evaluation, the case was diagnosed as a mesenteric cyst because the mass located in the mesentery, and final histopathological report revealed the urachal cyst.

RETROPERİTONEAL YUMUŞAK DOKU SARKOMDA KLİNİK DENEYİMLERİMİZ

Aim/Objective: Retroperitoneal soft tissue sarcoma; epidemiological, histopathological features of cases in our clinic, treatments and their clinical courses were compared with the literature. Materials and Methods: Records of 7 patients who were operated in Surgical Oncology Clinics of Suleyman Demirel University between 2007-2013 after being detected with primary retroperitoneal- intraperitoneal masses in imagings and being reported as soft tissue tumor in histopathological examination were analyzed retrospectively. Results: The patients were 6 males and 1 female. Abdominal tomography was applied to all patients and in imagings there were both intraperitoneal and retroperitoneal masses in 4 patients (57,1%), left retroperitoneal masses in 2 patients (28,6%) and intraperitoneal mass in 1 patient (14,3%). Distant metastases weren’t detected in any of the patients at the time of diagnosis. While mass excision was done in 2 patients, enbloc organs resection (colon and kidney) was done along with excision in 3 patients, two patients were admitted as unresectable. In pathological examination, 42,9% (in 3 patient) good differential liposarcoma, 28,6% (in 2 patient) leiomyosarcoma and 14.3% (1 patient) dedifferentiated liposarcoma and rhabdomyosarcoma were detected. Recurrence developed in 2 patients who were applied mass excision in 11th month (10th month and 12th month) on the average. Lung metastases developed in one patient in the 6th month who were applied enbloc organ and mass resection. Conclusion: Retroperitoneal soft tissue sarcomas are rarely seen. However, recurrence often develops generally due to incomplete surgery. Therefore, aggressive surgery is recommended in these tumors in order to provide negative surgery border

Memenin Paget Hastalığı Deneyimimiz

Objective: Pagets disease of the breast is a rare disease, is just 1-4.3% of all breast cancer patient and causing characteristic eczematous changes at the nipple. In this study, we aimed to present clinicopathological findings and treatment approach of the patients were treated surgically in the diagnosis of Pagets disease of thebreast. MaterialsandMethods: Thirteen patients medical records, which were treated for Pagets disease of the breast in our clinic between 2006 - 2013, were analyzed retrospectively. Results: 3.15% of patients admitted to our clinic with breast cancer has been diagnosed as Pagets disease of the breast. The median age of patients was 54 (29-87) years. It was found that the use of topical treatment of patients with lesion in the nipple causes delay in diagnosing. The other complaint of the patients was the breast mass. All patients were performed modified radical mastectomy procedure. Patients were followed up for an average of 27 (3-52) months. Radiologic examinations has shown there may be false-negative results. Ultrasonography showed no benefit, especially in patients with DCIS. There has been a patient with multiple bone metastases during follow-up. There was no recurrence or metastasis on the other patients. Conclusion: Pagets disease is primarily a clinical diagnosis. Topical treatments and diagnosing only based on radiological findings may cause delay in diagnosis. In consideration of occurrence of relapses, mastectomy is the Standard treatment. However, breast-conserving surgery can also be done in selected patients.