Bilateral primary squamous cell carcinoma of the ovary: a case report of isolated metastasis to the lateral pelvic wall

Primary squamous cell carcinoma of the ovary is rare. The majority of cases arise most commonly from the lining of a dermoid cyst, and less often in endometriosis or a Brenner tumor. A 40-year-old woman underwent exploratory laparotomy and was found to have a right ovarian tumor adherent to the lateral pelvic wall with no ascites. She underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, pelvic lymphadenectomy, infracolic omentectomy, appendectomy, and right nephrectomy for bilateral primary squamous cell carcinoma of the ovary. She was started on multiagent chemotherapy. On follow-up after two years the patient had died of cerebral metastases. To our knowledge in this report we present the first case in the English literature of bilateral pure squamous cell carcinoma of the ovary.

Superior vena cava syndrome caused by chemotherapy-induced fibrosis

We report a case of a 51-year old man with small cell lung cancer who developed superior vena cava syndrome due to obstruction of the superior vena cava at the junction of the brachiocephalic vein by a fibrotic band, 2 months after completing six cycles of chemotherapy with cisplatin and etoposid. Superior vena cava syndrome caused by chemotherapy-induced pulmonary fibrosis should be kept in mind during follow-up.

Acute effect of haemodialysis on serum markers of myocardial damage

Cardiac markers are more likely to be elevated in dialysis patients than in patients with renal failure not on dialysis. In this study, 31 patients (20 males, 11 females) undergoing chronic haemodialysis were enrolled. The effect of haemodialysis on cardiac troponin T (cTnT), I (cTnI), creatine kinase MB (CKMB) mass, CKMB activity and myoglobin assays was assessed by comparing pre- and post-haemodialysis determinations. After correcting for haemoconcentration, significant differences were observed (mean +/- SEM, pre- vs post-dialysis) for myoglobin (178.9 +/- 19.3 vs 225.0 +/- 28.4 ng/ml; p=0.006) for cTnT (0.111 +/- 0.028 vs 0.148 +/- 0.037 ng/ml; p=0.004), for CKMB mass (2.75 +/- 0.37 vs 2.59 +/- 0.37 ng/ml; p=0.000) and CKMB activity (14.8 +/- 0.9 vs 13.1 +/- 0.9 U/l; p=0.000) assays. Our study questions the reliability of cardiac markers in dialysis patients and suggests that the clinical threshold value and diagnostic efficiency of each assay needs to be validated. Although these differences exceeded clinical threshold values in only a few patients, serum markers of myocardial damage in dialysis patients should be interpreted with caution.

[Skin defect coverage with micro skin graft]

BACKGROUND

The aim of this study is to coverage of the large skin defect with microskin graft.

METHODS

The wound coverage of the large skin defect may be difficult with auto skin graft. In these patients, split thickness skin graft may be used in a bloc shape or expanded skin graft shape and a stamp skin graft shape or expanded stamp skin graft shape. On the other hand, split thickness skin graft may be used as a micrograft shape after the mincing process, which reduces of the graft size in a few millimeters. In this study, 6 patients with skin defect was admitted in our clinic, and their skin defect was treated with micro skin graft. Expansion ratio was 1:15.

RESULTS

Epithelialization on the wound surface was completed in 4 to 6 weeks and cobblestone appearance was observed after the wound coverage.

CONCLUSION

Skin defect coverage with micrograft is an effective technique like the other skin graft coverage methods.

Non-invasive imaging methods before fine-needle aspiration in the diagnosis of cervical masses

A carotid body tumour is a vascular tumour usually located at or around the bifurcation of the carotid artery and originating from the tunica adventitia. Carotid body tumours, which are generally non-functional and asymptomatic, grow slowly, which is why diagnosis can be delayed. Because of the vascular structures, fine-needle aspiration biopsy may be dangerous and impractical. Efficient and reliable methods of diagnosis, such as colour Doppler ultrasound, magnetic resonance imaging, computerised tomography and arteriography, can be useful. We report on a 58-year-old woman with diarrhoea, flushing and a cervical, hard, non-tender, fixed mass. An unsuccessful diagnostic fine-needle aspiration biopsy was performed after palpation of the cervical mass. A carotid body tumour was finally diagnosed. We concluded that non-invasive imaging methods should be evaluated before fine-needle aspiration in cervical masses. It should also be kept in mind that asymptomatic cervical masses may be related to non-local symptoms.

The efficacy of acetazolamide on visual functions in a patient with choroid metastasis of breast carcinoma

Breast carcinoma is the most frequent cancer in women and is the second leading cause of death. Choroid metastasis of breast carcinoma can be found either at presentation or in remission. It is frequently encountered in disseminated breast cancer with multiple organ metastasis. It has been proposed that the oedema-reducing effect of acetazolamide is due to stimulated ion and fluid removal from the retina to the choroid. A 40-year-old female patient on adjuvant chemotherapy for breast cancer was found to have an isolated choroid metastasis. Clinical and radiological remission was achieved after orbital radiotherapy, chemotherapy and acetazolamide treatment. In this case report, we emphasise the possible beneficial effect of acetazolamide in patients with choroid metastasis.

Dacarbazine-induced carotid artery and deep venous thrombosis in a patient with leiomyosarcoma: case report

Thromboembolic events are a common and important cause of morbidity and mortality in cancer patients that require early diagnosis and treatment. Reports have suggested that chemotherapeutic agents may contribute to this risk. In this case report, a 60-year-old male patient on chemotherapy (dacarbazine and doxorubicin) for leiomyosarcoma with no previous history of thromboembolism developed left carotid artery thrombosis 3 days after the first cycle of chemotherapy. A low molecular weight heparin was started for a possible cerebrovascular accident-related thrombosis. In the second cycle, he developed right femoral vein thrombosis only 2 days after initiating the chemotherapy. The chemotherapy protocol was changed and the patient did not develop any thrombosis during the 1-year follow-up. In the literature, no thrombotic complications have previously been reported due to either dacarbazine or doxorubicin. In conclusion, elderly patients on chemotherapy should be carefully monitored for thromboembolic complications and, in case of thrombosis, the chemotherapy protocol should be changed.

The epidemiology of elevated blood pressure as an estimate for hypertension in Aydin, Turkey

BACKGROUND

Hypertension is an important public health problem, with some variability of its epidemiological properties in different populations.

OBJECTIVES

The purpose of this study was to estimate the prevalence of hypertension and to determine the hypertension awareness, treatment and control rates in Aydin, a Turkish province.

METHODS

Of 1600 coincidentally selected people aged over 18 years in Aydin, 1480 (92.5%) had their blood pressure (BP) measured and answered a standard questionnaire in 1995.

RESULTS

Estimates of the prevalence of hypertension and its control were computed using two different criteria to define hypertension: BP > or =140/90 mm Hg or on treatment and BP > or =160/95 mm Hg or on treatment. Overall, the estimated prevalence of hypertension was 29.6% (for BP > or =140/90 mm Hg or on treatment). Hypertension prevalence increased progressively with age, from 9% in 18- to 29-year-olds to 70.6% in those 70-79 years of age. Women had a significantly higher prevalence than men (34.1% vs 26.0% respectively). Overall, 57.9% of hypertensive individuals were aware that they had high BP, and 82.1% of aware hypertensives were being treated with antihypertensive medications, but only 19.8% of treated hypertensives were under control (systolic pressure <140 mm Hg and diastolic pressure <90 mm Hg). In addition, housewives, unemployed, and the less educated individuals had greater mean systolic and diastolic BP.

CONCLUSIONS

Our results indicate that hypertension is highly prevalent in Aydin, Turkey, and the detection and control of hypertension is unsatisfactory.