Nail Aydin

Gender-Based Differences and Barriers in Skin Protection Behaviors in Melanoma Survivors

Purpose. Skin protection behaviors and environmental exposure play a crucial role in the development and subsequent management of melanoma. This study investigates gender-based differences in skin protection behaviors after melanoma treatment. Methods. Patients diagnosed and surgically treated for cutaneous melanomas over the last six years in a geographically high risk area were surveyed over telephone using a standardized script. Results. Of 150 survey results obtained, there were 82 males and 68 females. Overall, 87% of participants reported skin self-examination for abnormal markings more often and 94% reported wearing skin protective clothing more often, with females being more than males. Females limited outdoor activity more often than males, 79% to 54%, p < 0.05. When outside, females sought shade more often than males, 75% to 56%, p < 0.05. However, males wore a wide brim hat more often than females, 52% to 28%, p < 0.05. Interestingly, 60% of participants reported wearing SPF 30 sunscreen less often, p < 0.05. Conclusion. Larger percentage of females adopted behavioral changes to prevent future melanoma. Those living in high risk areas and with outdoor occupations need particular attention to skin care. Population based screening should be adopted to deal with this rising public health crisis.

Surgical versus conservative management of adult intussusception: Case series and review

Highlights • Adult intussusception has traditionally been considered an indication for surgery.• Transient intussusceptions are now detected with increased use of imaging.• In patients with low risk for underlying neoplasm, supportive care is sufficient.• Smaller intussusceptions are more likely to resolve with conservative treatment.

A common cancer in an uncommon location: A case report of squamous cell carcinoma of the nipple

Highlights • Squamous cell cancer of the nipple is rare but should be included in the differential diagnoses of pathologies of the nipple.• Patients with former history of skin cancer may present with skin cancers in unusual locations.• Thorough clinical and diagnostic evaluations are mandatory to rule out pathologiesand direct management decisions.

Capsular nevus versus metastatic malignant melanoma – a diagnostic dilemma

Highlights • There are many morphologic guidelines to recognize nodal nevus cells, but there are some cases where the prediction of behavior of certain cells may not be accurate solely based on histopathological findings.• Advanced histopathological techniques including implementing multiple markers should be employed in scenarios where distinguishing metastatic melanocytes from capsular nevi prove to be difficult.• We strongly encourage obtaining a second opinion from a second histopathologist, preferably at a high volume center in cases where benign and malignant distinctions are difficult to make.

A case report of symptomatic gallbladder disease in the setting of peritoneal carcinomatosis originating from invasive lobular carcinoma of the breast

Highlights • Gallbladder disease in peritoneal carcinomatosis from invasive lobular carcinoma.• Preferred initial evaluation for these patients is a diagnostic laparoscopy.• Portal involvement of carcinomatosis is a major concern.• A laparoscopic cholecystectomy can be undertaken selectively.• Treatment is dependent on laparoscopic findings and surgeon experience.

A Case Series of diffuse large B-cell lymphoma and burkitt lymphoma presenting with peritoneal lymphomatosis

Highlights • Diffuse large B-cell lymphoma (DLBCL) and Burkitt lymphoma can present with peritoneal lymphomatosis in rare cases.• Diagnosis cannot be obtained solely by history, physical examination, imaging, and cytology.• Biopsy of masses via CT guided imaging and/or laparoscopy can be beneficial in properly diagnosing non-Hodgkin lymphoma.

Disseminated coccidioidomycosis with molluscum-like lesions, diffuse lymphadenopathy, and splenomegaly in an immunocompetent patient

Coccidioidomycosis is caused by a dimorphic fungus species endemic to the arid and semi-arid regions of the Americas. The species have a terranean habitat producing a primary pulmonary infection by inhalation of arthroconidia. We describe a case of extrapulmonary coccidioidomycosis presenting with extensive lymphadenopathy, splenomegaly, and florid cutaneous lesions. This case is intended to heighten clinical suspicion in patients with risk factors.

Limitations in the use of 18F-FDG PET in the pre-operative staging of gastric cancer: A case series

Highlights • Whole body PET scan is commonly used to assess treatment response, particularly chemotherapy and for disease surveillance.• Various factors such as tumor size and location, histological subtype, and physiological FDG uptake by normal gastric wall influence the utility of FDG-PET in the staging workup of gastric cancer.• The significant cost of PET scan requires that its role in the preoperative evaluation of gastric cancer be reconsidered.

A rare presentation: A case report of osseous metaplasia and mature bone formation in a follicular adenoma of the thyroid

Highlights • Osseous metaplasia and bone formation may be seen in a broad spectrum of diseases involving the thyroid gland especially in malignant neoplasms of the thyroid gland.• However, this differentiation is not unique to malignant neoplasms. It may also be encountered in follicular adenomas of the thyroid.• Awareness of thyroid nodules undergoing hemorrhagic, cystic, and fibrotic changes, as well as calcification and ossification is paramount in proper diagnosis and treatment of these pathologies.• Particularly, patient’s history, associated risk factors and clinical presentation are the most important factors to consider in clinical differentiation of malignant and benign diagnoses.• All ossifications in a thyroid nodule should be considered suspicious for malignancy until proven otherwise.

Neuropraxia following resection of a retroperitoneal liposarcoma

Highlights • Neuropraxia after resection of retroperitoneal masses can be a challenging postoperative problem.• Intraoperative findings and postoperative suspicion have utmost importance in establishing differential diagnosis.• Postoperative work up including neurological evaluation, MRI, and EMG help in diagnosing the condition.• Aggressive postoperative physical therapy and steroids are very helpful in resolution of the condition.