H. Kalkan, M. Eryılmaz, D. Kiresi, H. Arbağ, A. Yesildag
Pott’s Puffy tumor is a rare disorder which is charactarized by frontal osteomyelitis and subperiosteal abscess as a complication of sinusitis. Nowadays we have forgotten this entity under the broad spectrum antibiotherapies for sinusitis. We reported an adolescent with chronic sinusitis suffered from forehead swelling and headache. He was performed ultrasound, computed tomography, magnetic resonans imaging for accurate diagnosis. Early diagnosis with appropriate imaging is necessary in order to avoid more severe complications, such as subdural empyema, septic thrombosis of the dural sinuses. Emergency physicians should remember Pott’s puffy tumor in differential diagnosis in patients presenting with forehead swelling and headache. Imaging modalities have an important role for the right diagnosis and guidance of the surgery. The thing that make this report special is the ultrasonographic images that are so rare reported in the literature. To our knowledge there are two reports which emphasized the sonographic findings of this entity.
{"title":"Pott's Puffy tumor: The role of ultrasound, computed tomography and magnetic resonance imaging in diagnosis","authors":"H. Kalkan, M. Eryılmaz, D. Kiresi, H. Arbağ, A. Yesildag","doi":"10.29333/EJGM/81883","DOIUrl":"https://doi.org/10.29333/EJGM/81883","url":null,"abstract":"Pott’s Puffy tumor is a rare disorder which is charactarized by frontal osteomyelitis and subperiosteal abscess as a complication of sinusitis. Nowadays we have forgotten this entity under the broad spectrum antibiotherapies for sinusitis. We reported an adolescent with chronic sinusitis suffered from forehead swelling and headache. He was performed ultrasound, computed tomography, magnetic resonans imaging for accurate diagnosis. Early diagnosis with appropriate imaging is necessary in order to avoid more severe complications, such as subdural empyema, septic thrombosis of the dural sinuses. Emergency physicians should remember Pott’s puffy tumor in differential diagnosis in patients presenting with forehead swelling and headache. Imaging modalities have an important role for the right diagnosis and guidance of the surgery. The thing that make this report special is the ultrasonographic images that are so rare reported in the literature. To our knowledge there are two reports which emphasized the sonographic findings of this entity.","PeriodicalId":12017,"journal":{"name":"European journal of general medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77754251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction:The risk of endothelial dysfunction and insulin resistance is higher in type 2 diabetes mellitus (T2DM) which could be modulated with exercise training. However, to our knowledge, there is no clinical studies have addressed which exercise specific type is superior in modulating biomarkers of endothelial dysfunction and insulin resistance for T2DM.This study aimed to determine the differences in response of biomarkers of endothelial dysfunction and insulin resistance to aerobic versus resistance exercises in type 2 diabetic patients.Material and Methods:Eighty obese type 2 diabetic patients participated in this study and were included into two groups, group (A) received aerobic exercises; where group (B) received resistance exercises for 12 months.Results:The mean values of Inter-Cellular Adhesion Molecule (ICAM-1), Vascular Cell Adhesion Molecule (VCAM-1), tissue plasminogen activator (tPA), E-selectin, glycosylated hemoglobin (HBA1c) and Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) were significantly decreased in both groups at the end of the study. However, the mean values of ICAM-1, VCAM-1 and t-PA antigen were more significantly reduced in group (A), while the mean values of HBA1c and HOMA-IR were more significantly reduced in group (B) and there were significant differences between both groups at the end of the study.Conclusions:Resistance exercise appears to be more beneficial than aerobic exercise for improving insulin resistance in T2DM. Also, aerobic exercise appears to be more beneficial than resistance exercise for improving endothelial function in T2DM.
{"title":"Biomarkers of endothelial function and insulin resistance response to aerobic exercise versus resistance exercises in obese type 2 diabetic patients","authors":"F. Al-Shreef, S. El-Kader","doi":"10.29333/EJGM/81880","DOIUrl":"https://doi.org/10.29333/EJGM/81880","url":null,"abstract":"Introduction:The risk of endothelial dysfunction and insulin resistance is higher in type 2 diabetes mellitus (T2DM) which could be modulated with exercise training. However, to our knowledge, there is no clinical studies have addressed which exercise specific type is superior in modulating biomarkers of endothelial dysfunction and insulin resistance for T2DM.This study aimed to determine the differences in response of biomarkers of endothelial dysfunction and insulin resistance to aerobic versus resistance exercises in type 2 diabetic patients.Material and Methods:Eighty obese type 2 diabetic patients participated in this study and were included into two groups, group (A) received aerobic exercises; where group (B) received resistance exercises for 12 months.Results:The mean values of Inter-Cellular Adhesion Molecule (ICAM-1), Vascular Cell Adhesion Molecule (VCAM-1), tissue plasminogen activator (tPA), E-selectin, glycosylated hemoglobin (HBA1c) and Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) were significantly decreased in both groups at the end of the study. However, the mean values of ICAM-1, VCAM-1 and t-PA antigen were more significantly reduced in group (A), while the mean values of HBA1c and HOMA-IR were more significantly reduced in group (B) and there were significant differences between both groups at the end of the study.Conclusions:Resistance exercise appears to be more beneficial than aerobic exercise for improving insulin resistance in T2DM. Also, aerobic exercise appears to be more beneficial than resistance exercise for improving endothelial function in T2DM.","PeriodicalId":12017,"journal":{"name":"European journal of general medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81918433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Fındık, H. Esen, M. Erdi, Pembe Oltulu, Naile Kökbudak, S. Gungor
Pilomyxoid astrocytomas are type of tumors rarely seen in the central nervous system as a variant of pilocytic astrocytoma. They are often localized in hypothalamic-chiasmatic area and seen in early childhood. They exhibit different histological characteristics and more aggressive behaviors compared to pilocytic astrocytomas. Although cases with malignant transformation were reported in pilocytic astrocytomas, no pilomyxoid astrocytoma patients was reported with malignant transformation. We have presented a pilomyxoid astrocytoma patient, since it is rarely seen in adulthood and shows malignant transformation histopathologically.
{"title":"Pilomyxoid astrocytoma showing malignant transformation in adult male","authors":"S. Fındık, H. Esen, M. Erdi, Pembe Oltulu, Naile Kökbudak, S. Gungor","doi":"10.29333/EJGM/81877","DOIUrl":"https://doi.org/10.29333/EJGM/81877","url":null,"abstract":"Pilomyxoid astrocytomas are type of tumors rarely seen in the central nervous system as a variant of pilocytic astrocytoma. They are often localized in hypothalamic-chiasmatic area and seen in early childhood. They exhibit different histological characteristics and more aggressive behaviors compared to pilocytic astrocytomas. Although cases with malignant transformation were reported in pilocytic astrocytomas, no pilomyxoid astrocytoma patients was reported with malignant transformation. We have presented a pilomyxoid astrocytoma patient, since it is rarely seen in adulthood and shows malignant transformation histopathologically.","PeriodicalId":12017,"journal":{"name":"European journal of general medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75620852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Inan, N. C. Sayın, E. Taştekin, Selen Gursoy-Erzincan, I. Uzun, Nurtaç Sarikaş, F. Varol
Chorioangioma is the most common tumor of the placenta. Since these tumors generally have small sizes, they cannot be detected during the routine ultrasonography (USG) examination and might not present any symptom. When they become larger in size, they can cause various maternal and fetal complications. We presented a patient whose obstetric USG examination revealed a placental mass compatible with chorioangioma and who had preterm delivery at the 34th gestational week. The size of the mass increased rapidly in last four weeks. The pathological examination indicated that the placental mass was 9x8 cm in size and compatible with angiomatous type chorioangioma.
{"title":"Placental chorioangioma complicated with preterm delivery: A case report","authors":"C. Inan, N. C. Sayın, E. Taştekin, Selen Gursoy-Erzincan, I. Uzun, Nurtaç Sarikaş, F. Varol","doi":"10.29333/EJGM/81873","DOIUrl":"https://doi.org/10.29333/EJGM/81873","url":null,"abstract":"Chorioangioma is the most common tumor of the placenta. Since these tumors generally have small sizes, they cannot be detected during the routine ultrasonography (USG) examination and might not present any symptom. When they become larger in size, they can cause various maternal and fetal complications. We presented a patient whose obstetric USG examination revealed a placental mass compatible with chorioangioma and who had preterm delivery at the 34th gestational week. The size of the mass increased rapidly in last four weeks. The pathological examination indicated that the placental mass was 9x8 cm in size and compatible with angiomatous type chorioangioma.","PeriodicalId":12017,"journal":{"name":"European journal of general medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87995626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tuberculomas constitute 5-30% of the space occupying lesions of central nervous system in developing countries. Children and young adults constitute the most affected population. Most common presentations of tuberculomas are cranial nerve palsies or focal neurological signs but presentation as isolated sixth nerve palsy is very rare. We report a case of an elderly female who presented with history of double vision for 2 months and was found to have isolated abducens nerve palsy of left eye due to tuberculoma in the ponto-medullary junction. Patient improved symptomatically within antitubercular treatment with complete recovery of eye movements.
{"title":"Tuberculoma presenting as isolated sixth nerve palsy: A rare case report","authors":"D. Jain, H. Aggarwal, A. Rao, Shaveta Dahiya","doi":"10.29333/EJGM/81875","DOIUrl":"https://doi.org/10.29333/EJGM/81875","url":null,"abstract":"Tuberculomas constitute 5-30% of the space occupying lesions of central nervous system in developing countries. Children and young adults constitute the most affected population. Most common presentations of tuberculomas are cranial nerve palsies or focal neurological signs but presentation as isolated sixth nerve palsy is very rare. We report a case of an elderly female who presented with history of double vision for 2 months and was found to have isolated abducens nerve palsy of left eye due to tuberculoma in the ponto-medullary junction. Patient improved symptomatically within antitubercular treatment with complete recovery of eye movements.","PeriodicalId":12017,"journal":{"name":"European journal of general medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91534453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction:Combination therapy with four drugs (isoniazid, rifampicin, pyrazinamid and ethambutol) is the treatment of choice in tuberculosis but hepatotoxicity due to these drugs is an important medical concern. Therefore identification of patient groups with increased risk for antituberculosis therapy induced hepatotoxicity is crucial.Material and Methods:This retrospective cohort study included hospitalized patients with the diagnosis of tuberculosis during a ten year period. Only patients with microbiological (culture positive) or histopathological (presence of granulomatous reaction with caseification necrosis in the tissue) evidence of tuberculosis infection were included. Incidence of hepatotoxicity and the association of hepatotoxicity with known and unknown risk factors were investigated.Results:Sixty four patients (33 female-31 male; median age 48.0 years) were included into the study. Most of the patients had extrapulmonary tuberculosis (n=49). Antituberculosis therapy was started with four drugs in all patients and 7 patients developed hepatotoxicity. Age, gender, previous tuberculosis history, extent of tuberculosis, positive hepatitis B virus serology, diabetes mellitus and chronic renal insufficiency were not related with the development of hepatotoxicity. The presence of rheumatologic disease and chronic corticosteroid use was associated with increased risk of hepatotoxicity (p<0.01 and p=0.01, respectively).Conclusions:In this study we found that patients with rheumatologic diseases and patients on chronic corticosteroid treatment had increased risk for hepatotoxicity during antituberculosis therapy. These patients should be closely monitored for hepatotoxicity especially during the initial treatment phase.Objective:To assess the rate of hepototoxicity due to antituberculosis drugs and to determine factors associated with hepatotoxicity in hospitalized tuberculosis patients.
{"title":"Risk factors for hepatotoxicity in patients hospitalized for tuberculosis","authors":"B. Ergan, E. Kirmizigul, O. Uzun, L. Coplu","doi":"10.29333/EJGM/81870","DOIUrl":"https://doi.org/10.29333/EJGM/81870","url":null,"abstract":"Introduction:Combination therapy with four drugs (isoniazid, rifampicin, pyrazinamid and ethambutol) is the treatment of choice in tuberculosis but hepatotoxicity due to these drugs is an important medical concern. Therefore identification of patient groups with increased risk for antituberculosis therapy induced hepatotoxicity is crucial.Material and Methods:This retrospective cohort study included hospitalized patients with the diagnosis of tuberculosis during a ten year period. Only patients with microbiological (culture positive) or histopathological (presence of granulomatous reaction with caseification necrosis in the tissue) evidence of tuberculosis infection were included. Incidence of hepatotoxicity and the association of hepatotoxicity with known and unknown risk factors were investigated.Results:Sixty four patients (33 female-31 male; median age 48.0 years) were included into the study. Most of the patients had extrapulmonary tuberculosis (n=49). Antituberculosis therapy was started with four drugs in all patients and 7 patients developed hepatotoxicity. Age, gender, previous tuberculosis history, extent of tuberculosis, positive hepatitis B virus serology, diabetes mellitus and chronic renal insufficiency were not related with the development of hepatotoxicity. The presence of rheumatologic disease and chronic corticosteroid use was associated with increased risk of hepatotoxicity (p<0.01 and p=0.01, respectively).Conclusions:In this study we found that patients with rheumatologic diseases and patients on chronic corticosteroid treatment had increased risk for hepatotoxicity during antituberculosis therapy. These patients should be closely monitored for hepatotoxicity especially during the initial treatment phase.Objective:To assess the rate of hepototoxicity due to antituberculosis drugs and to determine factors associated with hepatotoxicity in hospitalized tuberculosis patients.","PeriodicalId":12017,"journal":{"name":"European journal of general medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86517898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
İlknur Alkan-Kuşabbi, H. Aydoğmuş, H. Işık, A. Seven, B. Yuksel, Gülenay Gençosmanoğlu-Türkmen, D. Karçaaltıncaba, Y. Ergün, M. Çaydere, S. Batıoğlu
Introduction:To evaluate and compare the efficiencies of cytologic test methods conventional Pap smear (CVS) versus Thin Prep liquid-based cytology technique (TPT) in the histologic diagnosis of the precancerous lesions of the cervix and cervical cancer.Material and Methods:We selected randomly 1203 non-gravid women who were admitted to gynecology and menopause out-patient clinics of our hospital in the study. The cervical smear tests of all women were evaluated both using the conventional Pap smear and the TPT. Cytological examinations were compared according to their adequacy for evaluation. The evaluation of samples were performed and compared according to The Bethesda System.Results:The two screening methods were statistically compatible for evaluating the samples (κ=0,379 and p<0,001). The diagnosis interpreted by CPS and TPT methods were synchronous and this was also statistically significant (ĸ=0,829 ve p<0,001).Conclusions:Our cytohistologic diagnoses and samples' adequacy interpreted with CVS and TPT were statistically significantly synchronous.
{"title":"Is liquid-based cervical cytology test more effective than conventional pap smear?","authors":"İlknur Alkan-Kuşabbi, H. Aydoğmuş, H. Işık, A. Seven, B. Yuksel, Gülenay Gençosmanoğlu-Türkmen, D. Karçaaltıncaba, Y. Ergün, M. Çaydere, S. Batıoğlu","doi":"10.29333/EJGM/81871","DOIUrl":"https://doi.org/10.29333/EJGM/81871","url":null,"abstract":"Introduction:To evaluate and compare the efficiencies of cytologic test methods conventional Pap smear (CVS) versus Thin Prep liquid-based cytology technique (TPT) in the histologic diagnosis of the precancerous lesions of the cervix and cervical cancer.Material and Methods:We selected randomly 1203 non-gravid women who were admitted to gynecology and menopause out-patient clinics of our hospital in the study. The cervical smear tests of all women were evaluated both using the conventional Pap smear and the TPT. Cytological examinations were compared according to their adequacy for evaluation. The evaluation of samples were performed and compared according to The Bethesda System.Results:The two screening methods were statistically compatible for evaluating the samples (κ=0,379 and p<0,001). The diagnosis interpreted by CPS and TPT methods were synchronous and this was also statistically significant (ĸ=0,829 ve p<0,001).Conclusions:Our cytohistologic diagnoses and samples' adequacy interpreted with CVS and TPT were statistically significantly synchronous.","PeriodicalId":12017,"journal":{"name":"European journal of general medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85269571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rosai Dorfman disease is a rare disorder of histiocytes, which present as massive cervical lymphadenopathy. Here we describe a case of extranodal Rosai Dorfman disease involving the spinal cord. The patient presented with subacute progressive spastic paraparesis and numbness of both lower limbs. MRI of the spine showed an extradural mass extending from C3 to L1 level causing compressive myelopathy. Biopsy of the lesion was done through a D1 D2 laminectomy and the histopathology was consistent with Rosai Dorfman disease. We treated our case with one month steroids which resulted in clinical improvement and radiological resolution of the
{"title":"Spinal extradural Rosai Dorfman disease","authors":"J. James, J. Jose","doi":"10.29333/EJGM/81874","DOIUrl":"https://doi.org/10.29333/EJGM/81874","url":null,"abstract":"Rosai Dorfman disease is a rare disorder of histiocytes, which present as massive cervical lymphadenopathy. Here we describe a case of extranodal Rosai Dorfman disease involving the spinal cord. The patient presented with subacute progressive spastic paraparesis and numbness of both lower limbs. MRI of the spine showed an extradural mass extending from C3 to L1 level causing compressive myelopathy. Biopsy of the lesion was done through a D1 D2 laminectomy and the histopathology was consistent with Rosai Dorfman disease. We treated our case with one month steroids which resulted in clinical improvement and radiological resolution of the","PeriodicalId":12017,"journal":{"name":"European journal of general medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73293317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Korkmaz, Ramazan Yolacan, T. Teke, D. M. Yavşan
Lung cancer is known as a disease leading to metastases to all types of organs. Although covering a large part of the body and of much blood building-up, skeletal muscles are rare metastatic areas. In autopsies, less than 1% of malignant cancers that are spread hematogenously is known to lead to metastasis. A 51-year- old male patient diagnosed with squamous cell lung cancer and known to be in regression via screening after the administration of 32-day curative radiotheraphy and 6-cycle chemotherapy, the patient was radiologically followed-up. Four months later, he was admitted to outpatient clinic with the complaint of left hip pain. Magnetic resonance imaging revealed a lesion of nodular, necrotic metastatic mass within left gluteus muscles. As a result of tru-cut biopsy performed for the solid lesion, metastasis of carcinoma was detected. As also in our case, metastatic muscle disease should be suspected in patients with muscle pain.
{"title":"Gluteal region muscle metastasis from squamous cell lung carcinoma","authors":"C. Korkmaz, Ramazan Yolacan, T. Teke, D. M. Yavşan","doi":"10.29333/EJGM/81876","DOIUrl":"https://doi.org/10.29333/EJGM/81876","url":null,"abstract":"Lung cancer is known as a disease leading to metastases to all types of organs. Although covering a large part of the body and of much blood building-up, skeletal muscles are rare metastatic areas. In autopsies, less than 1% of malignant cancers that are spread hematogenously is known to lead to metastasis. A 51-year- old male patient diagnosed with squamous cell lung cancer and known to be in regression via screening after the administration of 32-day curative radiotheraphy and 6-cycle chemotherapy, the patient was radiologically followed-up. Four months later, he was admitted to outpatient clinic with the complaint of left hip pain. Magnetic resonance imaging revealed a lesion of nodular, necrotic metastatic mass within left gluteus muscles. As a result of tru-cut biopsy performed for the solid lesion, metastasis of carcinoma was detected. As also in our case, metastatic muscle disease should be suspected in patients with muscle pain.","PeriodicalId":12017,"journal":{"name":"European journal of general medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76561928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ceyda Sancakli-Usta, A. Usta, M. Karacan, M. Kanter, F. Ozen, K. Güzin, N. Yucel, Nurver Ozbay-Ozel, M. Takir
In this study, it is aimed to compare the diagnostic accuracy of preoperative magnetic resonance imaging (MRI) and intraoperative frozen section in determining the depth of myometrial invasion in patients with endometrioid type endometrial cancer. Retrospective evaluation of 69 patients with endometrioid type endometrial cancer who underwent preoperative MRI and subsequently intraoperative frozen-section and surgical staging between February 2004 and September 2011. Surgical staging was performed according to 2009 FIGO classification. Final histopathological examination was accepted as the standard of reference. The median age of patients was 59 years (range 41-80 years). Histopathological evaluation revealed that 41 patients had superficial myometrial invasion (<50% of myometrium) and 28 had deep myometrial invasion (≥50% of myometrium). Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 64.2%, 87.8%, 78.2%, 78.2% and 78.2% for MRI, and 89.3%, 97.6 %, 96.2 %, 93.0 % and 94.2% for frozen-section, respectively. The diagnostic accuracy of the intraoperative frozen-section was significantly higher than that of preoperative MRI according to McNemar’s test (p=0.03). A statistically significant negative correlation was found between MRI accuracy and tumor grade (p=0.0002). None of the other variables was associated with incorrect prediction of MRI. The rate of incorrect prediction of myometrial invasion with frozen-section was significantly higher in nonvisualized tumors (p=0.01). A significant difference was not detected with other variables and frozen-section. Intraoperative frozen section has a better accuracy compared to MRI in the assessment of myometrial invasion in endometrioid type endometrial cancer. MRI seems suboptimal in the identification of invasion to the myometrium.
{"title":"Preoperative MRI versus intraoperative frozen-section in the assessment of myometrial invasion in endometrioid type endometrial cancer","authors":"Ceyda Sancakli-Usta, A. Usta, M. Karacan, M. Kanter, F. Ozen, K. Güzin, N. Yucel, Nurver Ozbay-Ozel, M. Takir","doi":"10.29333/EJGM/81872","DOIUrl":"https://doi.org/10.29333/EJGM/81872","url":null,"abstract":"In this study, it is aimed to compare the diagnostic accuracy of preoperative magnetic resonance imaging (MRI) and intraoperative frozen section in determining the depth of myometrial invasion in patients with endometrioid type endometrial cancer. Retrospective evaluation of 69 patients with endometrioid type endometrial cancer who underwent preoperative MRI and subsequently intraoperative frozen-section and surgical staging between February 2004 and September 2011. Surgical staging was performed according to 2009 FIGO classification. Final histopathological examination was accepted as the standard of reference. The median age of patients was 59 years (range 41-80 years). Histopathological evaluation revealed that 41 patients had superficial myometrial invasion (<50% of myometrium) and 28 had deep myometrial invasion (≥50% of myometrium). Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 64.2%, 87.8%, 78.2%, 78.2% and 78.2% for MRI, and 89.3%, 97.6 %, 96.2 %, 93.0 % and 94.2% for frozen-section, respectively. The diagnostic accuracy of the intraoperative frozen-section was significantly higher than that of preoperative MRI according to McNemar’s test (p=0.03). A statistically significant negative correlation was found between MRI accuracy and tumor grade (p=0.0002). None of the other variables was associated with incorrect prediction of MRI. The rate of incorrect prediction of myometrial invasion with frozen-section was significantly higher in nonvisualized tumors (p=0.01). A significant difference was not detected with other variables and frozen-section. Intraoperative frozen section has a better accuracy compared to MRI in the assessment of myometrial invasion in endometrioid type endometrial cancer. MRI seems suboptimal in the identification of invasion to the myometrium.","PeriodicalId":12017,"journal":{"name":"European journal of general medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81980763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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