Papers by Fazilet Kayaselçuk
PubMed, 2011
Aim: The aim of this study is to describe our 10-year experience in patients with urogynecologica... more Aim: The aim of this study is to describe our 10-year experience in patients with urogynecological and colorectal carcinomas with radiation enteropathy treated surgically as an emergency, and to reassess symptoms and mortality. Patients and methods: The study included 17 patients receiving emergency surgery for complications of radiotherapy. Data about the patients and outcomes of the treatment alternatives used were retrospectively analyzed. Results: Of 17 patients, nine had colorectal cancer, six had gynecological cancer, and two had cancer of the urinary system. As an emergency, 12 patients had ileus only, one patient had intestinal fistulae and ileus, two patients had bleeding and ileus and two patients had perforation on admission. Seven patients underwent resection and anastomosis, two patients intestinal by-pass, four patients resection and ostomy and four patients bridectomy. Morbidity (75% for early complications and 100% for late complications) and mortality in the early postoperative period (25%) were higher in the patients undergoing bridectomy than in the patients undergoing other surgical methods. The rate of early and late complications (71.4% and 66.6%, respectively) was lower in the patients undergoing resection-anastomosis with a higher of quality life. Only 11 patients survived during a long follow-up period (64.7%). Conclusion: As the postoperative complication rate, overall and operative mortality of patients treated for radiation enteropaties as emergent surgery are high, specialists following this group of patients may favor removal of the pathologic tissue to avoid complications in the early and late postoperative period.
PubMed, 2004
We present a case of well-differentiated papillary mesothelioma discovered during staging surgery... more We present a case of well-differentiated papillary mesothelioma discovered during staging surgery for endometrial carcinoma in a 50-year-old postmenopausal woman. In case of simultaneous well-differentiated papillary mesothelioma (WDPM) and endometrial carcinoma, the surgeon may be mistaken by considering peritoneal implants as tumor metastasis. This situation may result in overtreatment of the patient. Thus a thorough pathologic examination of the specimens taking care not to miss any areas of invasion, and utilizing immunohistochemical analysis when necessary are important to avoid such mistakes. To our knowledge this is the first report of the simultaneous occurrence of endometrial carcinoma in conjunction with diffuse WDPM of the peritoneum.
Journal of Surgical Research, 2013
Background: There is a strong relationship between liver regeneration and angiogenesis and fibros... more Background: There is a strong relationship between liver regeneration and angiogenesis and fibrosis. It is known that Spironolactone, an aldosterone antagonist, acting on rennin ealdosterone axis, and Losartan, an angiotensin II type I antagonist, have both antifibrotic and antiangiogenic effects. Theoretically, the end result of these mechanisms with contradictory influences on liver regeneration is not known well. In this study, we aimed to reveal the effects on liver regeneration of administration of Spironolactone and Losartan, having contradicting effects on regeneration through antiangiogenesis and antifibrosis. Materials and methods: A total of 72 Wistar albino rats were divided into control, Spironolactone, and Losartan groups and subdivided to conduct examinations on days 1, 3, 5, and 7. The specimens were treated with proliferating cell nuclear antigen to evaluate the characteristics of liver regeneration; with phosphorylated Smad2 (phospho-Smad2), serum transforming growth factor beta (TGF-B) 1, and tissue TGF-B1 to evaluate the termination of regeneration and with vascular endothelial growth factor receptor 2, Flk-1/KDR, to evaluate angiogenesis. Results: The proliferating cell nuclear antigenelabeling index was found to be significantly higher in Spironolactone and Losartan groups than in the control group on days 1, 3, and 5
Placenta, Jul 1, 2003
Leiomyoma of the placenta is uncommon. We present a leiomyoma of the fetal membranes that was inc... more Leiomyoma of the placenta is uncommon. We present a leiomyoma of the fetal membranes that was incidentally discovered on examination of a spontaneously expulsed placenta following Caesarean section. Although it is an uncommon entity, it is known that leiomyomas may arise from the vasculature nourishing the fetal membranes. The baby was male and genetic studies were performed to detect Y chromosome in tumoral tissue. Polymerase chain reaction technique demonstrated Y chromosome in placental tissue but not in tumour tissue. Thus the tumour was finally diagnosed as incorporated benign uterine leiomyoma.
Transplantation, Sep 1, 2022
International journal of gynaecology and obstetrics, Oct 3, 2002
Objectives: To establish a relationship between hyperemesis gravidarum (HG) and Helicobacter pylo... more Objectives: To establish a relationship between hyperemesis gravidarum (HG) and Helicobacter pylori (H. Pylori) infection by histologic testing. Methods: Twenty patients with severe HG (Group I) and 10 volunteer pregnant women without gastric complaints (Group II) were included in the study. Endoscopic evaluations were done in both groups and biopsies were obtained from the antrum and corpus for the histopathologic diagnosis of H. pylori. The groups were compared with the x-test and Fisher's exact test where appropriate. Results: H. pylori was diagnosed in 19 2 (95%) of 20 patients in Group I and 5 (50%) of 10 patients in group II. H. pylori densities in the antrum and corpus were higher in Group I and the differences between the two groups were statistically significant. The biopsy specimens revealed significant inflammation and H. pylori activation processes in patients with HG, and in 18 of 19 patients inflammation scores were greater than q2 on the scale. Pangastritis was demonstrated by endoscopic examination in 17 of 20 patients with HG. Enterogastric reflux was also diagnosed in 10 patients. In the control group, three patients had antral gastritis. Conclusions: We suggest that in patients with intractable nausea and vomiting during pregnancy, pangastritis and enterogastric reflux are the main endoscopic findings and that these findings are closely associated with H. pylori infection, which can be diagnosed histologically. The degree of gastric complaints may be associated with the density of H. pylori infection.
International Surgery, Nov 1, 2014
Colorectal primary signet ring cell carcinoma (PSRCCR) is a rare entity with a dismal prognosis, ... more Colorectal primary signet ring cell carcinoma (PSRCCR) is a rare entity with a dismal prognosis, mainly because of delayed diagnosis. The objective of this study was to investigate the clinicopathologic features and prognostic factors for PSRCCR. This is a retrospective study including the data of 22 patients with PSRCCR who underwent surgery. Patients were categorized by age, sex, tumor site, and stage. Fifteen patients were male. Median age was 40 years. Sites for metastases were lymph nodes (86.4%), peritoneum (40.9%), and liver (9.1%). Most of the patients (91%) had stage III or IV tumors. The rates of curative and palliative resections performed were equal. Mean overall survival and mean progression-free survival times were found to be 33.3 6 7.1 months (95% confidence interval, 19.4-47.2 months) and 11.8 6 3.5 months (95% confidence interval, 4.9-18.7 months), respectively. It was concluded that site of the tumor, presence of bowel obstruction, peritoneum and lung metastases, adjacent organ infiltration, TNM stage, and efficiency of surgery have significant effects on survival. All in all, these aggressive tumors are generally diagnosed at advanced stages. Depending on the situation, survival is shorter. A high degree of vigilance is required for these patients to avoid the negative impact of late diagnosis on survival.
International Journal of Gynecologic Cancer, Sep 1, 2004
European Journal of Gynaecological Oncology, 2006
To evaluate the effect of body mass index (BMI) on clinical, surgical, pathologic features, and s... more To evaluate the effect of body mass index (BMI) on clinical, surgical, pathologic features, and surgical morbidity in the management of patients with endometrial cancer. All endometrial cancer patients who were surgically treated in our institution between January 1, 2003 and January 1, 2006 were eligible for the study. Forty-two out of 60 patients were included in the analysis from our cancer database. The patients were divided into three groups: BMI < 30, BMI 30-40, BMI > 40. Statistical analysis was performed by SPSS for Windows (version 11; SPSS, Inc., Chicago, IL). Lymphadenectomy as part of surgical staging was performed in 90.5% of all patients. Although patients with a BMI > 40 were less likely to have positive lymph vascular space invasion (LVSI) (p = 0.042), chance of deep myometrial invasion and positive lymph nodes (18%) were the same as for patients with a BMI < 30. Patients with a BMI > 40 had statistically longer operating times when compared to patients with a BMI < 40 (p = 0.039). Wound separation rate was statistically higher in the morbidly obese patients (p = 0.01). Average number of lymph nodes removed, hospital days, intraoperative and overall postoperative complication rates did not differ among the three groups (p > 0.05). This study confirms that comprehensive surgical staging can be performed adequately and safely in obese and morbidly obese endometrial cancer patients with no difference in length of hospital stay, intraoperative or postoperative complications. As a result adjuvant treatment of morbidly obese patients can be planned accordingly preventing under or over treatment.
Asian Journal of Neurosurgery
Oligodendrogliomas (ODGs) is a diffuse glial tumor that constitutes 4.2% of all brain tumors. Ext... more Oligodendrogliomas (ODGs) is a diffuse glial tumor that constitutes 4.2% of all brain tumors. Extraneural metastases, sometimes seen in glioblastoma multiforme, are extremely rare in ODG. In this report, we present a 63-year-old male patient who was diagnosed with Grade 3 ODG and had an intracranial mass resected in our clinic 4 years ago. The subject now presented with low back pain and was found to have widespread metastases. The prolongation of patient survival by current treatment regimens has revealed a growing number of ODG patients with metastases. We believe that back pain complaints in patients with ODG should be viewed as an indicator of metastasis.
Çağdaş Cerrahi Dergisi, 2002
European Journal of Breast Health, 2017
Stromal tumors are the prominent mesenchymal tumors of gastrointestinal tract (GIT) (1). They are... more Stromal tumors are the prominent mesenchymal tumors of gastrointestinal tract (GIT) (1). They are more apparent in upper middle age, mostly in 5 th and 6 th decades. They occur equally in both sexes (1). Gastrointestinal Stromal Tumors (GISTs) are most commonly localized in the stomach (40-70%) and may be found in the intestine (20-32%), colon (10%) and esophagus (5%) (1, 2). They also can be seen in extra-GIT sites like mesentery, omentum and retroperitoneum (2). Major patient complaints regarding GISTs are upper abdominal pain, GIT bleeding and abdominal masses (1). Interstitial cells of Cajal (ICC), which GISTs are thought to originate from, both express tyrosine kinase receptors (c-kit) and stain with CD34 and Vimentin. KIT (CD117) is a transmembrane tyrosine kinase receptor, which is expressed in hematopoietic stem cells, germ cells, mast cells, melanocytes and ICC (2). C-Kit positivity is an important parameter in diagnosis of GIST. Recently, a specific marker, namely discovered on GIST1 (DOG-1), has been discovered for GIST diagnosis. It is shown to be positive on ICCs and gastric surface epithelium. DOG-1 is also expressed in high amounts in KIT mutation-negative cases besides typical GIST cases (3). Immunohistochemical diagnosis of GIST is adopted when mesenchymal tumors stain positive with c-Kit (CD117) and the DOG-1 where the rest of mesenchymal cell markers were negative. Demonstration of CD117 and recently DOG-1 positivity immunochemically stands for the standard technique of definitive diagnosis of GIST. CD34 is positive in 70-80% of the cases. Vimentin is diffuse and strong positive in many stromal tumors. SMA is positive in 30-40% and S100 in 5% of GISTs. Staining with desmin is rare (1). Malignant stromal tumors mostly metastasize to liver, peritoneum, lungs and bones (4). Brain and lymph node metastases are unusual (4). No breast metastasis was presented in literature before. Hereby, we present a case of GIST with liver, bone, lymph node and breast metastases and aimed to discuss its unusual metastatic reviewing literature. Case Presentation A 46 year-old woman was referred to us from another health facility with the complaint of back pain. The radiological imaging studies revealed multiple liver metastases with the largest being 5.5 cm in diameter as well as multiple bone involvements. Positron Emission
Journal of experimental & clinical cancer research : CR, 2006
Angiogenesis plays an important role in tumor growth, metastasis, and prognosis. Vascular endothe... more Angiogenesis plays an important role in tumor growth, metastasis, and prognosis. Vascular endothelial growth factor (VEGF) is a potent endothelial mitogen and acts on the angiogenic stimulation of human neoplasias. In infiltrative ductal carcinoma (IDC), VEGF expression is correlated with high vascularity. Tumor-associated macrophages (TAMs) contribute to tumor proliferation, progression and angiogenesis and have a complex role in tumor biology. In this study, the correlations between microvessel density (MVD), VEGF expression, and TAMs and their relations to clinicopathological parameters such as tumor size, metastatic lymph node, mitotic activity index (MAI) and tumor grade were investigated in 48 cases of IDC and 30 infiltrative lobular carcinoma (ILC) cases. MVD showed a significant positive correlation with TAMs, VEGF, metastatic lymph nodes, tumor size and grade in IDC (P < 0.001). In ILC, MVD and tumor size were positively correlated (P = 0.003), while MVD was not correlat...
Iranian Red Crescent Medical Journal, 2014
Background: Diseases and tumors of the appendix vermiformis are very rare, except acute appendici... more Background: Diseases and tumors of the appendix vermiformis are very rare, except acute appendicitis. Objectives: This retrospective study was conducted to document the unusual findings in appendectomy specimens. Patients and Methods: Data of 1466 adult patients were gathered retrospectively. Appendectomy was performed in 1169 and in 297 patients following a diagnosis of acute appendicitis and during other abdominal operations, respectively. The data of 57 (3.88 %) patients who were pathologically reported to have unusual appendix findings were retrospectively collected. The records were analyzed according to patients' age, gender, clinical presentations, operative reports, pathological reports and follow up. Results: Unusual pathologic examination findings were detected in the appendectomy specimens of 57 patients with a mean age of 48.34 ± 19. Twenty-nine patients (50.8 %) were male and 28 (49.2 %) were female. Normal appendix tissues were observed in specimens of 26 (45.6 %) patients and inflamed appendix in 31 (54.3 %). The most common unusual finding was parasitic diseases of the intestine. Pathological diagnosis of malignancy and benign features were reported in specimens of 14 and 43 patients, respectively. Macroscopic evaluation of appendectomy specimens during surgery might result in negligence of the presence of unusual pathology. Conclusions: Even if the macroscopic appearance of the specimen is normal or acute appendicitis, we suggest routine histopathological examination.
Case Reports in Endocrinology, 2013
Metastatic insulinomas may sometimes present with recurrent life-threatening hypoglycemia episode... more Metastatic insulinomas may sometimes present with recurrent life-threatening hypoglycemia episodes. Such patients usually fail to respond to various therapeutic agents which causes constant dextrose infusion requirement. Herein, we present a resistant case of inoperable malignant insulinoma who was treated with many therapeutic agents and interventions including somatostatin analogues, Yttrium-90 radioembolization, everolimus, radiotherapy, and chemoembolization. Close blood sugar monitorization during these therapies showed the most favourable response with everolimus. Everolimus treatment resulted in rapid improvement of hypoglycemia episodes, letting us discontinue dextrose infusion and discharge the patient. However, experience with everolimus in such patients is still limited, and more precise data can be obtained with the increasing use of this agent for neuroendocrine tumours.
Pathology & Oncology Research, 2004
Placenta, 2003
Leiomyoma of the placenta is uncommon. We present a leiomyoma of the fetal membranes that was inc... more Leiomyoma of the placenta is uncommon. We present a leiomyoma of the fetal membranes that was incidentally discovered on examination of a spontaneously expulsed placenta following Caesarean section. Although it is an uncommon entity, it is known that leiomyomas may arise from the vasculature nourishing the fetal membranes. The baby was male and genetic studies were performed to detect Y chromosome in tumoral tissue. Polymerase chain reaction technique demonstrated Y chromosome in placental tissue but not in tumour tissue. Thus the tumour was finally diagnosed as incorporated benign uterine leiomyoma.
Pathology - Research and Practice, 2007
Fine needle aspiration biopsy (FNAB) is a method that is frequently used in the diagnosis for neo... more Fine needle aspiration biopsy (FNAB) is a method that is frequently used in the diagnosis for neoplastic and non-neoplastic thyroid lesions. However, despite the contribution of this method to diagnosis, varying degrees of histopathological alterations in thyroid tissue occur due to the trauma caused by the aspiration needle. In this study, we compared the histopathology of the thyroidectomy specimens obtained by FNAB with the specimens obtained without the use of FNAB. A hundred and fifty thyroidectomy specimens obtained by FNAB were compared histopathologically with 150 thyroidectomy specimens (control group) obtained without a FNAB procedure. The thyroidectomy specimens were evaluated for hemorrhage, fibrosis, siderophagia, vascular thrombosis, vascular proliferation, infarction, granulation tissue, cystic degeneration, papillary hyperplasia, nuclear atypia, mitosis, calcification, vascular invasion, capsular distortion (pseudoinvasion), cholesterol clefts, and the presence of metaplasia. The thyroidectomy specimens obtained by FNAB had rates of hemorrhage, siderophagia, granulation tissue, papillary hyperplasia, fibrosis, calcification, capsular distortion, cholesterol clefts (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001), and vascular thrombosis (P=0.001) that were statistically significantly higher than those obtained without FNAB. However, there were no clinically significant differences between the two groups in terms of vascular proliferation, nuclear atypia, mitosis, infarction, and oncocytic and squamous metaplasia. Alterations in thyroid tissue in association with FNAB show a considerable variation. Some of the alterations make diagnosis difficult, even leading to misdiagnosis in favor of carcinoma. Therefore, a thorough knowledge of possible alterations is essential to the differential diagnosis.
Onkologie, 2012
Schlüsselwörter CA 19-9 • Gallenerkrankung • Biliäre Obstruktion • Tumormarker Zusammenfassung Hi... more Schlüsselwörter CA 19-9 • Gallenerkrankung • Biliäre Obstruktion • Tumormarker Zusammenfassung Hintergrund: Die Bestimmung von Carbohydrate-Antigen (CA)-19-9-Spiegeln wird zur Diagnose und bei der Nachsorge von pankreatobiliären Karzinomen verwendet und hohe Spiegel dieses Biomarkers weisen auf eine maligne Erkrankung hin. Der CA-19-9-Spiegel kann auch bei Patienten mit nichtmalignen Erkrankungen erhöht sein, z.B. Cholostase, biliäre Obstruktio und Cholecystitis. Fallbericht: Ein 50-jähriger Patient wurde mit Ikterus und einem erhöhten CA-19-9-Spiegel (161 902 IU/ml) vorstellig. Wiederholte Biopsien des Gallenganges ergaben keine Malignität. Der radiologische Befund ergab eine Läsion, die in den Gallengang ragte. Die Positronenemissionstomography zeigte eine erhöhte 18 F-Fluoro-2-Deoxy-D-Glucose-Aufnahme in der Leber und eine Läsion, die einer Metastase ähnelte. Eine Whipple-Operation wurde durchgeführt und es wurde kein Tumor gefunden. Der postoperative CA-19-9-Spiegel sank auf normale Werte (27 IU/ml). Schlussfolgerung: Dieses Ergebnis zeigt, dass der CA-19-9-Spiegel nicht das einzige Kriterium für die Diagnose einer malignen Erkrankung sein sollte. Obwohl andere Analyseinstrumente die Diagnose unterstützen können, ist in manchen Fällen die operative Exploration notwendig, um Missdiagnosen zu vermeiden und festzustellen, ob die radiologischen Befunde falsch positiv waren.
Journal of Surgical Research, 2013
Background: There is a strong relationship between liver regeneration and angiogenesis and fibros... more Background: There is a strong relationship between liver regeneration and angiogenesis and fibrosis. It is known that Spironolactone, an aldosterone antagonist, acting on rennin ealdosterone axis, and Losartan, an angiotensin II type I antagonist, have both antifibrotic and antiangiogenic effects. Theoretically, the end result of these mechanisms with contradictory influences on liver regeneration is not known well. In this study, we aimed to reveal the effects on liver regeneration of administration of Spironolactone and Losartan, having contradicting effects on regeneration through antiangiogenesis and antifibrosis. Materials and methods: A total of 72 Wistar albino rats were divided into control, Spironolactone, and Losartan groups and subdivided to conduct examinations on days 1, 3, 5, and 7. The specimens were treated with proliferating cell nuclear antigen to evaluate the characteristics of liver regeneration; with phosphorylated Smad2 (phospho-Smad2), serum transforming growth factor beta (TGF-B) 1, and tissue TGF-B1 to evaluate the termination of regeneration and with vascular endothelial growth factor receptor 2, Flk-1/KDR, to evaluate angiogenesis. Results: The proliferating cell nuclear antigenelabeling index was found to be significantly higher in Spironolactone and Losartan groups than in the control group on days 1, 3, and 5
Uploads
Papers by Fazilet Kayaselçuk