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    A Single Center Experience of Parathyroid Carcinoma Which Is Less Common Among Parathyroid Tumors
    (2019) Erdoğan, Ahmet; Çetinkaya, Erdinç; Erdoğan, Kübra; Şahin, Samet; Üçkan, Enes Malik; Özkan, Murat Bulut; Tez, Mesut
    INTRODUCTION: Parathyroid tumors can be divided into three groups: parathyroid adenoma, atypical parathyroid adenoma and parathyroid carcinoma. Parathyroid carcinoma is the less common one among these. Parathyroid carcinomas account for approximately 0,005% of all cancers and 1% of primary hyperparathyroidism cases. In this study, we wanted to share our experience of parathyroid carcinoma which is not common. MATERIAL and METHODS: Of 375 patients who were operated with pre-diagnosis of parathyroid adenoma in Ankara Numune Training and Research Hospital Department of General Surgery between 2008 and 2015; 12 patients whose pathology result could not clearly identify a parathyroid carcinoma and could differentiate a carcinoma from an adenoma were examined retrospectively. RESULTS: Of the patients; 5 (41,6%) were observed to be male and 7 (58,4%) were observed to be female. Mean age was 54,5 (±8,40) and the age range was between 41 and 68. Mean preoperative calcium value was 12,3(±1,33) mg/dL and the range was between 10,9 and 15,3. The pathology results were as “a parathyroid carcinoma” in 4 patients, “a parathyroid neoplasm” in 4 patients, “a parathyroid neoplasm with undetermined malignant potential” in 3 patients and “malignancy could not be discarded” in 1 patient. Mean follow-up duration of the patients was 61,8 months (±17,05) and the range was between 35 and 96 months. 1 patient received chemotherapy and the same patient died on the month 55 during follow-ups. DISCUSSION AND CONCLUSION: In those with severe preoperative hypocalcemia symptoms, those with a calcium value higher than 14mg/dL, in cases when parathormone level is significantly higher and in cases when parathyroid gland is palpated, parathyroid carcinomas are suspected. For treatment of a parathyroid carcinoma, neck exploration, en-bloc removal of the tumor and ipsilateral lobectomy of thyroid are required. If pathology results are suspicious in regard to malignancy, and then the patient is closely followed-up.
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    Fournier gangreninde mortaliteyi öngörmede skorlama sistemlerinin değerlendirilmesi
    (2019) Er, Sadettin; Topcu, Ramazan; Tikici, Deniz; Özden, Sabri; Tez, Mesut
    Amaç: Fournier gangreni hastalarında şiddet ve mortaliteyi öngörmede skorlama sistemlerini değerlendirmeyi amaçladık.Gereç ve Yöntemler: Çalışmaya dahil edilen 76 hastanın demografik, klinik ve laboratuvar verileri elektronik ortamda retrospektif olarak incelendi. Çalışmada her hasta için demografik özellikleri, klinik ve laboratuvar parametrelerini içeren FGSI, UFGSI ve NFS skorları hesaplandı. Skorların ROC analizi yapıldı. Analizimiz sonucunda p<0,05 olanlar istatistiksel olarak anlamlı kabul edildi.Bulgular: Çalışmaya dahil edilen 76 hastanın 65(%85,5)’i taburcu edilirken, 11(%14,5)’inde mortalite gelişti. Tüm hastalar, Grup-1: Taburcu edilen hastalar ve Grup-2: Mortalite gelişenler olarak iki gruba ayrıldı. ROC((receiver operating characteristic) analizinde; FGSI, UFGSI ve NFS skorları için AUC (Area Under The Curve=Eğrinin Altında Kalan Alan) sırasıyla 0,890 (%95 CI: 0.785-0.994, p=0.000), 0,895 (%95 CI: 0.810-0.981, p=0.000) ve 0,867 (%95 CI: 0.733-1, p=0.000) olarak bulundu.Sonuç: İdeal bir skorlama sistemi; bu hastalığı daha iyi anlamak, beklenmedik mortalite durumlarında hataları tanımlayabilmek ve sağkalıma katkıda bulunabilmeyi amaçlamalıdır. NFS’nin basit, kolay değerlendirilen parametreler içeren bir skorlama sistemi olduğunu ve klinik pratikte mortaliteyi değerlendirmede oldukça faydalı olabileceğini düşünüyoruz.
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    Prognostic value of preoperative inflammation-based prognostic scores on hospital mortality after gastric cancer surgery
    (Asian Pacific Organization for Cancer Prevention, 2014) Dinç, Tolga; Yıldız, Barış Doğu; Kayılıoğlu, Selami Ilgaz; Sözen, İsa; Tez, Mesut; Coşkun, Faruk
    Gastric cancer is the fourth most common malignancy worldwide. Poor prognosis in gastric cancer is linked with hypoalbuminemia. Previous studies demonstrated relationships between gastric cancer and chronic inflammation. The aim of this study was to assess the prognostic value of preoperative inflammation-based prognostic scores regarding hospital mortality after gastrectomy. Unlike other recent articles on the same topic; we could only verify prognostic value of prognostic nutritional index for in hospital mortality after surgery.
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    Thyroid nodules with atypia or follicular lesions of undetermined significance (AUS/FLUS): analysis of variables associated with outcome
    (Asian Pacific Organization for Cancer Prevention, 2014) Kayılıoğlu, Selami Ilgaz; Dinç, Tolga; Sözen, İsa; Şenol, Kazım; Katar, Kağan; Karabeyoğlu, Melih; Tez, Mesut; Coşkun, Faruk
    Background: The Bethesda System for Reporting Thyroid Cytopathology is one of the main classification systems for thyroid nodules. It expects that 7% of all fine needle aspiration biopsies will be reported as atypia or follicular lesions of undetermined significance, and 5-15% of these undetermined nodules are malignant. Our study is a retrospective analysis of variables that may be associated with outcome in patients with indeterminate thyroid nodules. Materials and Methods: Patients who underwent thyroidectomy in our institution between 2010 and 2014 were retrieved from the institutional records database. Patient demographics and medical histories were recorded. All ultrasonography reports were examined for nodule features and biochemical blood levels, hormone levels and complete blood counts were recorded. Results: A total of 103 patient cytopathology reports were regarded as belonging to the undetermined category. Some 35% of patients had malignant nodules. Median preoperative red cell distribution width (RDW) level was 13.6 inthe benign group, while it was 14.3 in patients with malignancy, demonstrating a significant correlation (p = 0.003). Only calcification presence was significantly different between benign and malignant groups on ultrasonography (p = 0.034). Conclusions: Ultrasonography is one of the primary tools for this matter. RDW levels may become another promising tool to predict malignancy.