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IntroductionSitus inversus totalis (SIT) is a very rare condition that is seen at a rate of one in about 6000–8000 births.AimTo offer a general view on the coexistence of SIT and gastric cancer, accompanied by a literature review.Material and methodsWithin the scope of this study, the case of a patient with gastric adenocarcinoma and SIT has been presented. Previous research on gastric cancer cases with SIT was reviewed through a comprehensive search of the PubMed, Medline, and Google Scholar databases. The keywords used to conduct this research were “situs inversus totalis and gastric cancer,” “situs inversus totalis and gastric malignant,” and “situs inversus totalis and gastric resection.” The database search covered English studies published between 2000 and 2016.ResultsThe results of our literature review revealed 20 studies of patients with gastric cancer and SIT, and 21 related cases. Overall, 12 of the patients were male, 9 were female, and their mean age was 61.8 ±10.97 years. The vascular assessment data showed that three out of the 13 mentioned cases had vascular anomalies. Eleven of the patients had laparoscopic resections, and one of the patients that had a surgical procedure exhibiting a postoperative mechanical obstruction.ConclusionsThe coexistence of SIT and gastric cancer is a very rare condition, and a careful preoperative radiological assessment should be conducted because there can be accompanying vascular anomalies. Laparoscopies and robotic surgeries can be performed for suitable patients at experienced centres, consistent with oncological principles.

Endovascular interventions are increasingly used in the treatment of a splenic artery aneurysm (SAA), which is a rare and life-threatening clinical disorder. However, in cases of SAA rupture, minimally invasive interventions are unsuitable, and open surgery remains the gold standard method. In open surgery, care should be taken to preserve the spleen and its immune function in cases where an arterial segment of sufficient length allows for reconstruction. An SAA was detected in a 51-year-old woman who presented to our polyclinic with left upper quadrant pain. An endovascular intervention was unsuccessful, and open surgery was performed. Approximately 5 cm of aneurysm in the middle segment of the splenic artery was treated by arterial anastomosis, and the spleen was preserved. The patient experienced no postoperative complications and remained asymptomatic at the seventh month of follow-up. The aim of this case report is to emphasize the importance of splenic sparing surgery in cases of SAAs.

Objective: The relationship between primary hyperparathyroidism (pHPT) and papillary thyroid cancer (PTC) still remains unclear. We aimed to investigate the incidence of the co-existence of pHPT and PTC. Materials and Methods:Between 2010 and 2013, all patients with pHPT were retrospectively reviewed and those undergoing concomitant thyroid surgery were recorded. Of these, patients with a pathological result showing papillary or micro-papillary thyroid cancer were included into the study. A chart review of 228 patients who underwent surgery for pHPT revealed 86 (37.7%) patients with concurrent thyroid disease requiring surgical treatment. Results:Thyroid cancer was noted in six female patients (6.9%) undergoing thyroid resection, and 2.6% of all patients with pHPT. Four patients underwent total thyroidectomy while lobectomy was applied in the remaining two. None of the cases with lobectomy required a completion thyroidectomy. Conclusion:We demonstrated the concurrence of PTC and pHPT at a rate of 2.6% which appeared as a coincidental pathology; however, thyroid disorders, seen in one of three patients with pHPT, were not uncommon. Further research is still needed to develop a reliable explanation for relationship between pHPT and non-medullary thyroid cancer.Keywords: Primary hyperparathyroidism, thyroid disorders, surgical treatment, papillary thyroid cancer Özet Amaç: Her ne kadar primer hiperparatiroidi (pHPT) ile medüller tiroid kanser ilişkisi bilinse de papiller tiroid kanseri ile ilişkisi halen net değildir. Biz bu çalışmada pHPT tanısı nedeniyle opere ettiğimiz hastalardaki papiller tiroid kanser sıklığını incelemeyi amaçladik. Gereç ve Yöntem:Primer HPT tanısı ile 2010 ve 2013 yılları arasın-da eş zamanlı tiroid cerrahisi uygulanan hastalar retrospektif olarak incelendi. Bu hastalardan patoloji sonucunda papiller veya mikropapiller trioid kanseri tanısı alan hastalar çalışmaya dahil edildi. Çalış-ma sürecinde pHPT tanısı ile cerrahi tedavi uygulanan 228 hastadan 86'sında (%37,7) ek tiroid cerrahisi uygulandığı saptandı. Bulgular:Ek tiroid cerrahisi uygulanan 6 kadın hastada (%6,9)-pHPT hastalarının %2,6'sı tiroid kanseri saptandı. Dört hastada total tiroidektomi papiller diğer 2 hastada lobektomi yapıldı. Hastaların hiçbi-rinde tamamlayıcı tiroidektomiye ihtiyaç duyulmadı. Sonuç:Primer HPT hastalarında %30 oranında tiroid patolojisi izlenmesine rağmen %2,6 gibi düşük bir orandaki tiroid kanser birlikteliği tesadüfi olarak ilişkilendirilebilir. Fakat medüller olmayan tiroid kanseri ile pHPT arasındaki bağa daha güvenilir bir açıklama getirebilmek için ileri çalışmalar gerekmektedir.