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Hekimoglu A, Ergun O, Birgi E, Balas S. Endovascular treatment of femoral artery blow-out caused by skin malignancy. Egypt J Radiol Nucl Med 2022. [DOI: 10.1186/s43055-022-00732-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Vascular blow-out syndrome is a life-threatening bleeding condition that usually occurs in the carotid arteries as a result of invasion of head and neck malignant tumors. There are several case reports in the literature on peripheral vascular blow out. To our knowledge, there is no other case report in the literature on blow-out in the femoral artery secondary to skin malignancy.
Case presentation
A 66-year-old male patient, who was diagnosed with skin squamous cell carcinoma (SCC) as a result of tissue sampling due to redness and stiffness in the left inguinal region, underwent emergency surgery with severe bleeding. Since edema and deformations on the skin did not render the operation possible, the patient was taken to the interventional radiology unit by applying pressure compression onto the bleeding area for urgent endovascular treatment. The patient was treated with a stent-graft.
Conclusion
The femoral blow-out is an emergency condition that needs to be managed aggressively, and if left untreated, it can cause serious bleeding, limb ischemia, limb loss, or death. Endovascular stent-graft placement is the first method that should be considered, and this method provides fast and effective treatment.
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Saydam M, Yilmaz KB, Sahin M, Yanik H, Akinci M, Yilmaz I, Balas S, Azili C, Gulcelik MA. New Findings on Autoimmune Etiology of Idiopathic Granulomatous Mastitis: Serum IL-17, IL-22 and IL-23 Levels of Patients. J INVEST SURG 2021; 34:993-997. [PMID: 32046543 DOI: 10.1080/08941939.2020.1725190] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Idiopathic Granulomatous Mastitis (IGM) is a benign chronic inflammatory breast disease that mimics breast cancer, and the etiopathogenesis has not yet been fully evaluated. Autoimmunity has received the most focus as a possible etiology. Our aim in this prospective clinical study was to investigate the possible association between the cytokines, interleukin IL-17, IL-22, IL-23 and IGM. MATERIALS AND METHODS The current study was conducted in 26 women with histopathologically diagnosed IGM, and 15 control women of reproductive age having no breast disease history. Blood samples were collected, and serum concentrations of IL-17, IL-22, and IL-23 were determined. RESULTS In the analysis of variables, the patients with IGM and the control group had statistically significant differences between serum IL-22 titers (p = 0.0378) and IL-23 titers (p = 0.0469. No statistically significant difference was found between IGM patients and the control group in serum IL-17 titers (p = 0.9724). CONCLUSION The results of the current study, especially pertaining to serum IL-22 and IL-23 levels, support the etiopathogenesis of IGM in favor of the autoinflammatory thesis. Nevertheless, this thesis should be supported by a large case number and prospective clinical studies.
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Affiliation(s)
- Mehmet Saydam
- Department of General Surgery, University of Health Sciences, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Kerim Bora Yilmaz
- Department of General Surgery, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey
- Department of Medical and Surgical Research, University of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Mutlu Sahin
- Department of General Surgery, University of Health Sciences, Ankara Kecioren Training and Research Hospital, Ankara, Turkey
| | - Hamdullah Yanik
- Department of Basic Oncology, Cancer Institute, Hacettepe University, Ankara, Turkey
| | - Melih Akinci
- Department of General Surgery, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Ibrahim Yilmaz
- Department of General Surgery, University of Health Sciences, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Sener Balas
- Department of General Surgery, University of Health Sciences, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Cem Azili
- Department of General Surgery, University of Health Sciences, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Mehmet Ali Gulcelik
- Department of General Surgery, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey
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Ünlü A, Yılmaz S, Akbasli IT, Karaagac Akyol T, Akkapulu N, Tumer M, Ertugrul Oruc N, Balas S, Goral S, Topcuoglu P, Tanriseven M, Sayin S, Eryilmaz M. MATRA-A: A study on massive transfusion. Vox Sang 2021; 116:880-886. [PMID: 33634885 DOI: 10.1111/vox.13082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 01/18/2021] [Accepted: 01/18/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND We use massive transfusion in various clinical conditions and it is associated with high mortality. Although some massive transfusion protocols improve patient outcomes, the clinical circumstances requiring it are not well defined. METHODS MATRA-A is a multicenter retrospective study. Six University and Training Research Hospitals in Ankara participated in the study. We collected clinical data on patients (>18 years) who received massive transfusions (≥10 units/24 h) from 2017 through 2019. RESULTS Overall, 167 (0·27% of transfused patients) received a massive transfusion of 2586 units of red blood cells (1·5% of total RBCs transfused). The median interquartile range values for RBCs, fresh frozen plasma (FFP) and platelets were 13 (11-176), 16 (9-33) and 4 (0-11), respectively. Surgical patients received 90% of massive transfusions. The most common clinical indications for massive transfusion were cardiovascular diseases (42·6%), trauma (20·3%) and malignancies (11%). FFP: RBC: Platelets ratio was 1·9:1:0·5. The overall and trauma-related mortality rates were 57·4% and 61·8%, respectively. The hospital mortality rates of trauma patients that received high vs. low ratio (FFP: RBCs > 1:1·5 vs. ≤1:1·5) transfusions were 47·6% and 86·6% and the difference was statistically significant (P = 0·03). CONCLUSION Cardiovascular diseases and trauma occasion are the most common causes of massive transfusion. It is infrequent in clinical settings and is associated with high mortality rates. Additionally, in massively transfused trauma patients, a high FFP:RBCs ratio seems to be associated with increased survival. Focused prospective studies are required to define the areas that need improvement on a national scale.
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Affiliation(s)
- Aytekin Ünlü
- Department of General Surgery, Gulhane Traning and Research Hospital, Health Science University, Ankara, Turkey
| | - Soner Yılmaz
- Regional Blood Center, Gulhane Traning and Research Hospital, Health Science University, Ankara, Turkey
| | | | - Tulay Karaagac Akyol
- Department of Blood and Transfusion Center, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Nezih Akkapulu
- Department of General Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Murat Tumer
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Nigar Ertugrul Oruc
- Department of Blood and Transfusion Center, Diskapi Yildirim Beyazit Traning and Research Hospital, Health Science University, Ankara, Turkey
| | - Sener Balas
- Department of General Surgery, Diskapi Yildirim Beyazit Traning and Research Hospital, Health Science University, Ankara, Turkey
| | - Seniz Goral
- Department of Blood and Transfusion Center, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Pervin Topcuoglu
- Department of Blood and Transfusion Center, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Mustafa Tanriseven
- Department of General Surgery, Gulhane Traning and Research Hospital, Health Science University, Ankara, Turkey
| | - Selim Sayin
- Department of General Medicine, Kecioren Traning and Research Hospital, Health Science University, Ankara, Turkey
| | - Mehmet Eryilmaz
- Department of General Surgery, Gulhane Traning and Research Hospital, Health Science University, Ankara, Turkey
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Yilmaz KB, Saydam M, Tokgoz S, Akinci M, Balas S, Azili C, Karabacak H, Akkoca M. A novel monitorization technique for nerve protection during axillary surgery of the breast cancer patients. Breast J 2019; 26:809-811. [PMID: 31564058 DOI: 10.1111/tbj.13644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 09/11/2019] [Accepted: 09/13/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Kerim Bora Yilmaz
- Department of General Surgery, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Ankara, Turkey
| | - Mehmet Saydam
- Department of General Surgery, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Ankara, Turkey
| | - Serhat Tokgoz
- Department of General Surgery, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Ankara, Turkey
| | - Melih Akinci
- Department of General Surgery, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Ankara, Turkey
| | - Sener Balas
- Department of General Surgery, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Ankara, Turkey
| | - Cem Azili
- Department of General Surgery, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Ankara, Turkey
| | - Harun Karabacak
- Department of General Surgery, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Ankara, Turkey
| | - Muzaffer Akkoca
- Department of General Surgery, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Ankara, Turkey
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Akkoca M, Balas S, Yilmaz KB, Tatar IG, Akinci M, Tokgoz S, Tamam S, Karabacak H. CT-guided tractography is a safe and complementary diagnostic tool in the management of penetrating abdominal trauma. Asian J Surg 2018; 42:148-154. [PMID: 30585169 DOI: 10.1016/j.asjsur.2018.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 05/07/2018] [Accepted: 05/28/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND/OBJECTIVE Despite extensive published research, the surgical approach to penetrating abdominal trauma patients is still under debate. Computed tomography-guided tractography (CTT) is an imaging modality in which water soluble iodinated contrast medium is administered into the site of the injury in the CT unit. The aim of this study was to determine the diagnostic accuracy of the CTT. METHODS A retrospective evaluation was made of patients admitted to the Emergency Department with penetrating abdominal trauma and who underwent CTT. Contrast enhanced abdominal CT and CTT reports, surgical findings and clinical results were examined. RESULTS Evaluation was made of a total of 101 patients comprising 89 males (88.1%) and 12 females (11.9%). CTT was determined to have 92.8% sensitivity, 93.6% specificity, 97% positive predictive value, and 85.5% negative predictive value. In 27 patients (26.7%) where the CTT indicated passage through the peritoneum, no parenchymal organ injury was present. Only one patient (2.9%) without peritoneal penetration on CTT had organ injury at exploration. No procedure-related morbidities developed. CONCLUSION CTT is a safe imaging modality for the evaluation of hemodynamically stable patients. Compared to other imaging modalities, there is clearer demonstration of whether or not the peritoneum is intact. However penetration on CTT does not exactly correlate with organ injury.
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Affiliation(s)
- Muzaffer Akkoca
- University of Health Sciences, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Department of General Surgery, Ankara, Turkey.
| | - Sener Balas
- University of Health Sciences, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Department of General Surgery, Ankara, Turkey
| | - Kerim Bora Yilmaz
- University of Health Sciences, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Department of General Surgery, Ankara, Turkey
| | - Idil Gunes Tatar
- University of Health Sciences, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Department of Radiology, Ankara, Turkey
| | - Melih Akinci
- University of Health Sciences, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Department of General Surgery, Ankara, Turkey
| | - Serhat Tokgoz
- University of Health Sciences, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Department of General Surgery, Ankara, Turkey
| | - Selim Tamam
- University of Health Sciences, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Department of General Surgery, Ankara, Turkey
| | - Harun Karabacak
- University of Health Sciences, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Department of General Surgery, Ankara, Turkey
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Yilmaz KB, Akinci M, Tamam S, Tokgoz S, Balas S, Akkoca M, Karabacak H. Comment on "What is the diagnostic value of computed tomography tractography in patients with abdominal stab wounds?". Eur J Trauma Emerg Surg 2016; 43:279-280. [PMID: 27447831 DOI: 10.1007/s00068-016-0715-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 07/19/2016] [Indexed: 11/26/2022]
Affiliation(s)
- K B Yilmaz
- Department of General Surgery, Ankara Diskapi Training and Research Hospital, Diskapi-Altındag, 06110, Ankara, Turkey.
| | - M Akinci
- Department of General Surgery, Ankara Diskapi Training and Research Hospital, Diskapi-Altındag, 06110, Ankara, Turkey
| | - S Tamam
- Department of General Surgery, Ankara Diskapi Training and Research Hospital, Diskapi-Altındag, 06110, Ankara, Turkey
| | - S Tokgoz
- Department of General Surgery, Ankara Diskapi Training and Research Hospital, Diskapi-Altındag, 06110, Ankara, Turkey
| | - S Balas
- Department of General Surgery, Ankara Diskapi Training and Research Hospital, Diskapi-Altındag, 06110, Ankara, Turkey
| | - M Akkoca
- Department of General Surgery, Ankara Diskapi Training and Research Hospital, Diskapi-Altındag, 06110, Ankara, Turkey
| | - H Karabacak
- Department of General Surgery, Ankara Diskapi Training and Research Hospital, Diskapi-Altındag, 06110, Ankara, Turkey
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Tatar IG, Yilmaz KB, Arikok A, Bayar B, Akinci M, Balas S, Ergul Z, Ergun O, Hekimoglu B. Cystic schwannoma of the axillary region: imaging findings of a rare disease. Case report. Med Ultrason 2015; 17:126-128. [PMID: 25745668 DOI: 10.11152/mu.2013.2066.171.kyb] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Schwannomas are well capsulated, benign, and slowly growing tumors which originate from Schwann cells of peripheral nerve sheath. The incidence of schwannomanas in the axillary region is not common. This rarity causes misdiagnosis at the radiological evaluation. In this case we present the imaging and histopathological findings of a cystic schwannoma located in the axillary fossa of a 47-year-old female patient mimicking complex cyst, lymphadenopathy or hydatid cyst in radiological evaluation. Although lymphadenopathy, lymphatic malformation, lipoma, cyst, hidradenitis suppurativa or dermatofibroma are the most frequent lesions to be considered, peripheral nerve sheath should also be kept in mind in the differential diagnosis of axillary masses.
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Affiliation(s)
- Idil Gunes Tatar
- Department of Radiology, Ankara Diskapı Training and Research Hospital, Ankara, Turkey. E-mail:
| | - Kerim Bora Yilmaz
- Department of General Surgery, Ankara Diskapı Training and Research Hospital, Ankara, Turkey
| | - Ataturker Arikok
- Department of Pathology, Ankara Diskapı Training and Research Hospital, Ankara, Turkey
| | - Bahattin Bayar
- Department of General Surgery, Ankara Diskapı Training and Research Hospital, Ankara, Turkey
| | - Melih Akinci
- Department of General Surgery, Ankara Diskapı Training and Research Hospital, Ankara, Turkey
| | - Sener Balas
- Department of General Surgery, Ankara Diskapı Training and Research Hospital, Ankara, Turkey
| | - Zafer Ergul
- Department of General Surgery, Ankara Diskapı Training and Research Hospital, Ankara, Turkey
| | - Onur Ergun
- Department of Radiology, Ankara Diskapı Training and Research Hospital, Ankara, Turkey
| | - Baki Hekimoglu
- Department of Radiology, Ankara Diskapı Training and Research Hospital, Ankara, Turkey
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Akpinar E, Turkbey B, Karcaaltincaba M, Balli O, Akkapulu N, Balas S, Tirnaksiz B, Akata D, Akhan O. Initial experience on utility of gadobenate dimeglumine (Gd-BOPTA) enhanced T1-weighted MR cholangiography in diagnosis of acute cholecystitis. J Magn Reson Imaging 2009; 30:578-85. [PMID: 19711404 DOI: 10.1002/jmri.21887] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
PURPOSE To investigate the feasibility of the use of gadobenate dimeglumine (also known as Gd-BOPTA) -enhanced T1-weighted MR cholangiography in diagnosis of acute cholecystitis. MATERIALS AND METHODS This prospectively designed institutional review board-approved HIPAA-compliant study was done between January and November 2007. We included 11 consecutive patients (7 male, mean age 59 years) who presented to the emergency room with acute right upper quadrant pain and with equivocal physical examination and/or ultrasound findings. The control group included 15 patients who underwent liver MRI with Gd-BOPTA. All patients underwent contrast-enhanced (CE) MR cholangiography examinations. CE-MR cholangiography was performed on a 1.5 Tesla magnet using 3D T1-weighted high resolution isotrophic volume examination (THRIVE) obtained at the 90th min after intravenous injection of Gd-BOPTA. Imaging features detected on CE-MR cholangiography were correlated with operative and histopathologic findings. RESULTS In the control group, GD-BOPTA was visualized within the gallbladder in all subjects. For the study group, gallstones were present in nine patients (n = 7 both in gallbladder and cystic duct, n = 1 only in gallbladder, n = 1 only in cystic duct) on MRCP. Hydropic gallbladder was detected in seven patients, significant wall thickening in seven patients, and pericholecystic free fluid in 6 patients. On delayed phase CE cholangiography, significant enhancement of gallbladder wall was seen in 10 patients, and contrast agent excretion into gallbladder was absent in all patients. Surgery was performed in 10 patients, and cholecystostomy was done in 1 patient. Surgery and histopathology findings were consistent with cholecystitis in all patients. CONCLUSION In addition to anatomical assessment, Gd-BOPTA-enhanced MR cholangiography can provide functional evaluation similar to HIDA scintigraphy in diagnosing acute cholecystitis in patients with acute right upper quadrant pain and equivocal findings.
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Affiliation(s)
- Erhan Akpinar
- Hacettepe University School of Medicine, Department of Radiology, Ankara, Turkey
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Coşkun F, Aksu NM, Akpinar E, Bozkurt S, Akkaş M, Balas S, Karakiliç E. [Non-occlusive mesenteric ischemia in a chronic dialysis patient: a case report]. ULUS TRAVMA ACIL CER 2008; 14:256-259. [PMID: 18781426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
We report non-occlusive mesenteric ischemia (NOMI) in a patient with hemodialysis-dependent chronic renal failure who presented with acute onset of abdominal pain. On abdominal computed tomography (CT) and CT angiography, pneumatosis intestinalis of the small intestine and mesenteric venous gas were found with patent superior and inferior mesenteric arteries. CT also showed bowel wall thickening with fat stranding at terminal ileum. In emergency laparotomy, necrosis of the terminal ileum over a 4 cm area was identified and the ischemic segment was resected. Histopathological exam was consistent with gangrenous enteritis. Herein, we present exquisite imaging findings of a NOMI case with an overview of related literature.
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Affiliation(s)
- Figen Coşkun
- Department of Emergency Medicine, Medicine Faculty of Hacettepe University, Ankara, Turkey.
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Deniz K, Ozşeker HS, Balas S, Akpýnar E, Sökmensüer C. Intestinal involvement in Wegener's granulomatosis. J Gastrointestin Liver Dis 2007; 16:329-331. [PMID: 17925931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Wegener's granulomatosis is a necrotizing vasculitis that may affect any viscera. Gastrointestinal involvement is rather uncommon. We present a case of Wegener's granulomatosis with multiple small bowel ulcers and a single ileal perforation. Histological examination of the surgically resected specimen demonstrated evidence for necrotizing vasculitis. Gross and histological features of the gastrointestinal disease in Wegener's granulomatosis are discussed.
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Affiliation(s)
- Kemal Deniz
- Department of Pathology, Faculty of Medicine, Erciyes University, 38039 Kayseri, Turkey.
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Keskek M, Balas S, Gokoz A, Sayek I. Re-evaluation of axillary skip metastases in the era of sentinel lymph node biopsy in breast cancer. Surg Today 2006; 36:1047-52. [PMID: 17123131 DOI: 10.1007/s00595-006-3322-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2006] [Accepted: 06/09/2006] [Indexed: 02/06/2023]
Abstract
PURPOSE To investigate whether skip axillary metastases are really skip metastases or a continuation of level I micrometastases in invasive breast cancer, and to determine whether there are any factors predisposing to skip metastases. METHODS We reviewed 568 consecutive patients with breast cancer who underwent complete axillary lymph node dissections (ALND) between January 1998 and December 2004. For patients with skip axillary lymph node metastases, resectioning and immunohistochemical staining of the remaining part of paraffin blocks from level I lymph nodes were done to determine whether there were any micrometastases in this group of lymph nodes. RESULTS Skip axillary metastases were found in 27 (10%) of 268 patients with axillary lymph node metastases. Re-evaluation of the level I lymph nodes, both with thin sectioning and immunohistochemical staining, in the patients with axillary skip metastases revealed no micrometastases. No significant correlation was found between the demographic and histopathological variables of the patients with skip metastases and those with regular axillary metastases. CONCLUSIONS These results suggest that skip axillary metastases are actual skip metastases, not a continuation of undetected level I micrometastases. Moreover, none of the clinical and histopathological measures of primary tumors are predictors of the presence of skip metastases.
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Affiliation(s)
- Mehmet Keskek
- Fifth Department of Surgery, Ankara Numune Training and Research Hospital, Ankara, Turkey
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