GÝRÝÞ ve AMAÇ: Bu çalýþmada ekstremite yerleþimli intramusküler hemanjiom tanýlý, takip ve tedavisi yapýlmýþ 44 hastanýn retrospektif analizi incelenmiþtir
YÖNTEM ve GEREÇLER: Hastalarýn 25’i kadýn, 19’u erkek idi. Hemanjiomlarýn 22’si uylukta, 8’i bacakta, 6’sý önkolda, 4’ü dirsekde, 2’si üst kolda, biri omuzda ve biri popliteal bölgede idi. Malignite þüphesi olan 10 hastaya tru-cut biyopsi yapýldý. Diðer hastalara klinik ve radyolojik olarak taný konuldu. Hastalarýn 32’si izleme alýnýrken, 12’sine cerrahi eksizyon uygulandý.
BULGULAR: Hiçbir hastada ameliyat içi komplikasyon olmadý. Cerrahi gruptaki 3 hastaya embolizasyon uygulandý. Postoperatif takiplerde 1 hastada enfeksiyon, 2 hastada nüks saptandý.
TARTIÞMA ve SONUÇ: Semptomatik ekstremite yerleþimli intramusküler hemanjiomlarda kitlede progresyon olmasý, ekstremite fonksiyon bozukluðu olmasý, malignite þüphesi ve giderilemeyen aðrý durumlarý dýþýnda, izlemin güncel tedavi yöntemi olduðunu düþünmekteyiz.

INTRODUCTION: In this study, we evaluated the retrospective analysis of 44 patients with the diagnosis of extremity located intramuscular hemangiomas
METHODS: Twenty five of the patients were female, and nineteen male. Twenty two of the hemagiomas were in thigh,8 were in cruris, 6 were in forearm,4 in elbow,2 in arm,one in shoulder, one in popliteal area. Ten patients who had malignancy potential, were maken tru-cut biyopsy. The other patients were diagnosed with clinical and radiological signs. Thirty two patients were followed up. 12 were treated surgery total excision.
RESULTS: No intraoperastive complications were recorded. Three patients were treated with embolization, one of the patient was recorded local infection, two were recorded recurrens
DISCUSSION AND CONCLUSION: The current treatment of the symptomatic extremity located intramuscular hemangiomas is conservative follow up, if the patients has not progressive mass, extremity dysfunction, malignancy suspicion and intarctable pain.

GÝRÝÞ ve AMAÇ: Ýnvaziv fungal enfeksiyonlar (IFE) sýklýkla immün süpresif hastalarda görülmektedir. Antifungal tedavi baþarýsý için erken taný anahtar öneme sahiptir. Betaglucan (BG) testi mucormikoz ve kriptokoklar dýþýnda birçok mantar patojeni tespit edebilir. Bu çalýþmada betaglucan düzeyinin hematolojik kanserli ve IFE’li hastalarda tanýsal bir araç olarak deðerlendirmeyi amaçladýk.
YÖNTEM ve GEREÇLER: Indüksiyon veya konsolidasyon tedavisi alan, klinik ve radyolojik IFE bulgularý olmayan 14 günden uzun süreli nötropeni beklentisi olan 46 hasta çalýþmaya dahil edildi. Hastanede yattýklarý süre içerisinde haftada 2 defa kan galaktmannan (GM) ve BG düzeyleri ölçüldü. Sensitivite, spesifite ve öngörðlen deðerlerin yorumlanmasý için Metod A (kanýtlanmýþ + muhtemel grup vs non-IFE) ve Metod B (kanýtlanmýþ + muhtemel +olasý grup vs non-IFE ) deðiþkenleri tanýmlandý.
BULGULAR: Metod A’da; BG testinin sensitivitesi, spesifitesi, pozitif öngörülen deðer (PÖD), Negatif öngörülen deðer (NÖD) sýrasýyla %68.75, %84.1, %52.4, %91.4 olarak tespit edildi. Metod B’de; BG testinin sensitivitesi, spesifitesi, PÖD, NÖD sýrasýyla %60, %88.9, %71.4, %82.8 olarak tespit edildi.
Hiçbir hastada ameliyat içi istenmeyen durum olmadý. Cerrahi gruptaki 3 hastaya embolizasyon uygulandý. Postoperatif takiplerde 1 hastada enfeksiyon, 2 hastada nüks saptandý.
TARTIÞMA ve SONUÇ: Bizim verilerimiz ve mevcut literature dayanarak BG ve GM’nin IFE tanýsýna katký saðlayan non-invaziv test olduðu sonucuna vardýk.

INTRODUCTION: Invasive fungal infections (IFI) are commonly seen in immunosuppressive patients. Early diagnosis is key to optimizing antifungal treatment success. Betaglucan (BG) assay can detect most of the fungal pathogens except mucormycosis and Cryptococcus. In this study we aimed to evaluate the value of BG as a diagnostic tool in patients with hematological malignancy and IFI.
METHODS: Forty-six hematological malignancy patients under induction and consolidation chemotherapy that expected to have neutropenia for more than 14 days with no clinical and radiological signs of IFI are included in this study. Blood Galactomannan (GM) and BG levels were measured 2 times in a week during the hospitalization period. Method A (proven + probable groups vs non IFI) and Method B (proven + probable + possible groups vs. non IFI) variables were determined to assess the sensitivity, specifity and predictive values.
RESULTS: In method A; BG test’s sensitivity, specifity, positive predictive value (PPV), negative predictive value (NPV) was determined as 68.75%, 84.1%, 52.4%, 91.4% respectively. In method B (proven + probable + possible groups vs. non IFI) BG test sensitivity, specifity, PPV, NPV was determined as 60%, 88.9%, 71.4%, and 82.8% respectively.
DISCUSSION AND CONCLUSION: Depending on our data and present literature; we conclude that BG and GM is a non-invasive contributory test for the diagnosis of IFI The current treatment of the symptomatic extremity

GÝRÝÞ ve AMAÇ: Bu çalýþmamýzda amacýmýz; proksimal femoral kilitli kompresyon plaðý ile tedavi ettiðimiz, pertrokanterik kýrýðý olan 48 hastanýn, erken dönem radyografik ve klinik sonuçlarý ile tedavi yönteminin stabil olmayan kýrýklarda da avantajlarýný ortaya koymaktýr.
YÖNTEM ve GEREÇLER: Hastalarýn 28’i kadýn, 20’si erkek idi. Hastalarýn 8 inde subtorkanterik kýrýk, 40 hastada intertrokanterik kýrýk mevcuttu. Hastalarýmýzýn hastaneye baþvuru anýndan sonra ameliyat olma süreleri ortalama 2,2 gün olarak belirlendi. Hastalarýn tamamýna proksimal femoral kilitli kompresyon plaðý ile stabilizasyon yapýldý.
BULGULAR: Hastalarýn ortalama takip süresi 11,8 ay olarak belirlendi. 48 hastanýn 1’inde derin ve 2’sinde yüzeyel olmak üzere 3 (%6) hastada enfeksiyon geliþti. 48 hastanýn 43’ünde (%89) kaynama saðlandý.
TARTIÞMA ve SONUÇ: Çalýþmamýzda, pertrokanterik femur kýrýklarýnýn tedavisinde proksimal femoral kilitli kompresyon plaðýnýn kullanýlmasý ile post operatif morbiditenin daha düþük, kaynama süresinin ise daha kýsa olduðunu bulduk.

INTRODUCTION: The aim of this study is to analyze the early radiologic and clinical results of 48 patients with pertrochanteric fractures treated with proximal femoral locked plates and the advantage of this treatment method in non stable fracture patterns
METHODS: 28 female and 20 male patients were analyzed. Subtrochanteric fractures in 8 and intertrochanteric fractures in 40 patients were recorded. The mean period for operation after admission to hospital is 2.2 days. Proximal femoral locked plate was used for reconstruction in all patients.
RESULTS: Patients were followed up for a mean period of 11.8 months. 1 deep and 2 superficial infections were recorded. Bony union was examined in 43 of 48 patients (89%).
DISCUSSION AND CONCLUSION: In this study, we analyzed that, proximal femoral locked plate is a good surgical option for pertrochanteric fractures as it provides low morbidity rates and shorter union time.

GÝRÝÞ ve AMAÇ: Göz kapaðý ve konjoktivadan yapýlan kitle eksizyonlarýnýn histopatolojik sonuçlarýný gözden geçirmeyi amaçladýk.
YÖNTEM ve GEREÇLER: Ocak 2012- Ocak 2015 arasý göz kapaðý ve konjoktivadan kitle eksizyonu yapýlan 81 hastanýn yaþý,cinsiyeti, kitle eksizyon yeri, histopatolojik sonuçlarý gözden geçirildi.
BULGULAR: Otuzyedisi (% 46) erkek, 44’ü (% 54 ) kadýn olan 81 hastanýn ortalama yaþý 46,3 ± 18,9 (3-84) idi. 16 hastadan konjoktival doku eksizyonu, 65 hastadan göz kapaðý kitle eksizyonu yapýlmýþtý. Göz kapaðý tümörü olan olgularýn 11 inde squamöz papillom, 22 hastada intradermal nevus, 2 hastada seboroik keratoz, 2 hastada epidermal inkülüzyon kisti, 6 olguda inflamatuar lezyon, kapiller hemanjiom 1 olguda, ksentelezma 2 olguda, dermoid kist 3 olguda, verruca vulgaris 2 olguda, 4 olguda sebase kist, 1 hastada bening ekrin tumor, 1 olguda keratoakantoma, 1 hastada pilomatrixoma görüldü. Kötü huylu olan tümörlerde 5 olguda bazal hücreli karsinoma, 1 hastada bazosquamöz, 1 hastada sebase bez karsinom görüldü. Konjoktiva dokularýnda 4 pterjium, 6 hastada konjoktival melanositik lezyon, 6 hastada ise pyojenik granuloma görüldü.
TARTIÞMA ve SONUÇ: Kitlelerin histopatolojik taný daðýlýmýný ýrk, yaþ, cinsiyet, yaþanýlan yer, güneþ ýþýðý maruziyeti ve klinik araþtýrmanýn yapýldýðý hastanenin kapak ve konjuktival kiitle lezyonlar için referans bir merkez olmasý etkili olabilir.

INTRODUCTION: To review the histopathologic outcomes of our tumour excisions from eyelid and conjunctiva.
METHODS: Forty-six hematological malignancy patients under induction and consolidation chemotherapy that expected We retrospectively studied the age, gender, tumour excision localization, and histopathologic outcomes of 81 patients who had undergone eyelid or conjunctiva tumour excision surgery between January 2012 and January 2015.
RESULTS: Our study analyzed data of 81 patients, 37 (%46) of whom were male and 44 (%54) of whom were female. The mean age was 46,3 ± 18,9 (3-84 ) years. Sixteen patients had undergone conjunctiva tumour excision, 65 patients undergone eyelid tumour excision. From the cases who had eyelid tumour, 11 had squamous papilloma, 22 had intradermal nevus, 2 had seborrheic keratosis, 2 had epidermal inclusion cycst, 6 had inflammatory lesion, 1 had capillary hemangioma, 2 had xanthelasma, 3 had dermoid cycst, 2 had verruca vulgaris, 4 had sebaceous cycst, 1 had benign ecrine tumour, 1 had keratoacanthoma, 1 had pilomatrixoma. From the malignant tumours, 5 cases had basal cell carcinoma, 1 case had basosquamous cell carcinoma, 1 case had sebaceous glang carcinoma. From the conjunctiva tissues 4 pterygium, 6 conjunctival melanocytic lesion, and 6 pyogenic granuloma were observed.
DISCUSSION AND CONCLUSION: The histopathologic diagnosis of eyelid and conjunctiva tumours might be affected by race, age, gender, residence, sunlight exposure, and the clinical research hospital’s being a reference center.

GÝRÝÞ ve AMAÇ: Bu çalýþmada kliniðimizde cerrahi tedavi uygulanan arka ayak yerleþimli benign kemik tümörlü 24 hastanýn retrospektif analizinin incelenmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Hastalarýn 18’i erkek, 6’sý kadýn idi. Tümörlerin 16’sý kalkaneus, 8’i talusta idi. Hastalarýn hepsine açýk biyopsi yapýldý ve sonucuna göre cerrahi tedavi planlandý.
BULGULAR: Hiçbir hastada ameliyat içi komplikasyon olmadý. En sýk karþýlaþýlan tümör osteokondrom idi. Postoperatif takiplerde 3 hastada enfeksiyon saptandý. Hiçbir hastada nüks saptanmadý.
TARTIÞMA ve SONUÇ: Arka ayak yerleþimli tümör olgularýnda en sýk baþvuru þikayeti aðrý olup taný için tümöral lezyonlar mutlaka akla getirilmeli ve tedaviye yanýtsýz her hasta ileri görüntüleme tetkikleri ile deðerlendirilmelidir. Özellikle talus tümörleri anatomik yapýsý gereði ve teþhiste ileri radyolojik tetkikler gerektirmesi nedeniyle sýkça gözden kaçabilmektedir. Görüntüleme yöntemleri sonrasýnda, kesin taný için mutlaka biyopsi uygulanmalýdýr.

INTRODUCTION: In this study we retrospectively aimed to analyze the 24 patients with the diagnosis of benign hindfoot tumor who were surgically treated.
METHODS: Eighteen of the patients were male, and six were female. Sixteen of the tumors were in calcaneus and eight were in talus. Open biopsy was performed for all the patients and the surgical planning was decided according to histopathologic results.
RESULTS: The most common tumor was osteochondroma. Local infection was encountered in three of the patients. No intraoperative complication was recorded. No recurrence was detected in any patients.
DISCUSSION AND CONCLUSION: The most common complaint of patients with hindfoot tumors was pain and a possible bone tumor should be kept in mind and radiological interventions should be ordered for the diagnosis of the patients unresponsive to treatment. Because of its unique anatomic structure and the requirement for detailed imaging studies, talus located bone tumors can easily be skipped. Finally, biopsy should be performed to confirm the diagnosis following radiologic interventions.

GÝRÝÞ ve AMAÇ: Ýnvaziv lobüler karsinoma meme kanserinin ikinci en sýk görülen histolojik tipi olmasýna raðmen, klinikopatolojik özelliklerinin prognostik önemi halen tartýþmalýdýr. Bu çalýþmanýn amacý invaziv lobüler meme karsinomalý hastalarda mastektomi sonrasý hastalýksýz saðkalýmý etkileyen faktörleri tanýmlamaktýr.
YÖNTEM ve GEREÇLER: 2006-2011 yýllarý arasýnda modifiye radikal mastektomi ile tedavi edilen invaziv lobüler karsinomalý 68 hastanýn kayýtlarý geriye dönük olarak deðerlendirildi. Yaþ, menopoz durumu, patolojik tümör boyutu, patolojik lenf nodu durumu, grade, patolojik evre, lenfovasküler invazyon, östrojen reseptörü, progesteron reseptörü ve human epidermal growth faktör reseptör-2 durumunun hastalýksýz saðkalým üzerindeki etkisi tek ve çok deðiþkenli analizlerle incelendi.
BULGULAR: Ortanca takip süresi 49 ay (21-83 ay) idi. Beþ yýllýk genel saðkalým %92, 5-yýllýk hastalýksýz saðkalým ise %85 olarak bulundu. Bir hastada lokal nüks (%1,5), 9 hastada uzak metastaz (%13,2) geliþtiði, 4 hastanýn da kaybedildiði (%5,9) belirlendi. Tek deðiþkenli analizde tümör boyutu, lenf nodu durumu, evre, lenfovasküler invazyon, östrojen reseptörü ve progesteron reseptörü durumunun hastalýksýz saðkalým üzerinde anlamlý etkiye sahip olduðu saptandý. Çok deðiþkenli analizde ise, bu faktörlerden tümör boyutu (Hazard ratio [HR]= 6,4, %95 güven aralýðý [GA]= 1,2-21,2, P=0,001) ve lenf nodu durumunun (HR=4,8, %95 GA= 1,1-15,4, P=0,01) hastalýksýz saðkalým için baðýmsýz risk faktörleri olduðu belirlendi.
TARTIÞMA ve SONUÇ: Tümör çapý 4 cm.den büyük ve aksiller lenf nodu pozitif olan invaziv lobüler meme kanserli hastalarda hastalýksýz saðkalým daha kötüdür.

INTRODUCTION: Although invasive lobular carcinoma is the second most common histotype of breast cancer, the prognostic implications of its clinicopathologic characteristics remain controversial. The aim of this study was to identify the factors affecting disease-free survival after mastectomy in patients with invasive lobular carcinoma.
METHODS: The records of 68 patients with invasive lobular carcinoma treated with modified radical mastectomy between 2006 and 2011 were retrospectively evaluated. The effects of age, menopausal status, pathological tumor size, pathological lymph node status, histological grade, pathological stage, lymphovascular invasion, estrogen receptor status, progesterone receptor status, and human epidermal growth factor receptor-2 status on disease-free survival were examined by univariate and multivariate statistical analyses.
RESULTS: The median follow-up time was 49 months (range 21 to 83). Five-year overall survival and disease-free survival rates were 92% and 85%, respectively. One patient had local recurrence (1.5%) and distant metastasis developed in 9 patients (13.2%). Four patients died during follow-up period (5.9%). In univariate analysis, tumor size, lymph node status, stage, lymphovascular invasion, oestrogen receptor status, and progesterone receptor status had significant effect on disease-free survival. Of these, tumor size (hazard ratio [HR]= 6,4; 95% confidence interval [CI]= 1,2-21,2; P=0,001) and nodal status (HR= 4,8; 95% CI= 1,1-15,4; P=0,01) were determined as independent risk factors on disease-free survival in multivariate analysis.
DISCUSSION AND CONCLUSION: Disease-free survival in invasive lobular breast cancer patients who have tumor size greater than 4 cm and positive axillary lymph node is worse.

Kolorektal ve nöroendokrin tümörlerde hepatik metastazektominin klinik faydasý çok iyi tanýmlanmýþ olmasýna karþýn, diðer tümörlerinde bu uygulamanýn yeri çok net deðildir. Bu yazýda over karsinosarkomuna baðlý sað hemidiafragma ve sað akciðer alt lobunu invaze etmiþ karaciðer metastazlý bir olgu sunmaktayýz. Bu olguya abdominal giriþim uygulanmadan transtorasik olarak yaklaþýlmýþ ve sað hemidiafragma, akciðer ve karaciðer rezeksiyonu uygulanmýþtýr. Hasta bu cerrahi giriþim sonrasý ortalama 2,5 yýl (27 ay) yaþamýþtýr. Primer jinekolojik malignitelere baðlý uzak organ metastazlarýnda da, düþük morbidite ve mortalite oranlarý ve sað kalýmý uzamasý nedeniyle senkron hepatik ve pulmoner metastazektomi uygulanabilir. Bu alanda kýsýtlý tecrübeler olmasýna raðmen özellikle subdiafragmatik karaciðer ile sað akciðere olan metastazlarda, transtorasik senkron pulmoner ve hepatik metastazektomi akýlda tutulmalýdýr.

Although hepatic metastasectomy is well established for colorectal and neuroendocrine tumors, the treatment of hepatic metastases from other sites is not well defined. We present a case of ovarian carcinosarcoma with liver metastasis that invaded the right hemidiaphragm and lower lobe of right lung. En bloc transthoracic lung, right hemidiaphragm and liver resection was performed without using an abdominal incision. The patient survived nearly 2.5 years (27 months) after this surgery. Synchronous hepatic and pulmonary metastasectomies can be recommended for the metastatic tumors from the primary gynecologic malignancies. This procedure can be done with low morbidity, mortality rates and prolonges survival. Inspite of the limited experience, the choice of transthoracic synchronous pulmonary and hepatic metastasectomy should be remembered for the patients with subdiapragmatic liver and right sided lung metastasis.

Bleomisin’in mukokutanöz yan etkileri, 100 U'den daha yüksek kümülatif dozlarý alan hastalarda yaygýndýr. Flagella benzeri hiperpigmentasyon bleomisin kullanýmýnýn neden olduðu, vakalarýn yaklaþýk % 8-20'sinde görülen ilginç bir cilt reaksiyonudur. Mekanizmasý bilinmemektedir. Taný karakteristik klinik görünüme dayanmaktadýr. Hiperpigmente cilt lezyonlarýnýn histolojik incelemesi, bazal keratinositlerde artmýþ melanin içeriðini ortaya koymaktadýr. Hafif vakalar antihistaminiklere ve/veya sistemik steroide yanýt verir fakat birçok vakada ilacýn kesilmesi gerekebilir. Biz rölatif olarak daha düþük (kümülatif dozlar 30 ve 38 U) dozlarla bleomisin kaynaklý flagella benzeri hiperpigmentasyonu olan 2 vaka sunuyoruz. Bleomisin kullanan hastalarda hiç de nadir olmayan bu komplikasyonu klinisyenler akýlda bulundurmalýdýrlar.

Mucocutaneus side effects of bleomycin therapy are common in patients receiving cumulative doses greater than 100 U (100 mg). Flagellate hyperpigmentation is an interesting cutaneus reaction caused by bleomycin use, and is seen in about 8-20% of cases. The mechanism is unknown. Diagnosis is based on its characteristic clinical appearance. Histological examination of hyperpigmented skin lesions has demonstrated increased melanin content in basal keratinocytes. It has been suggested that mild cases may respond to antihistamines and ⁄ or systemic steroids, but in many cases discontinuation of the drug may be necessary. We present two patients (cumulative doses of 30 and 38 U) that developed bleomycin-induced flagellate hyperpigmentation with relatively low doses. Because the condition is not uncommon in patients who are using this drug, the clinician should be mindful of this complication.