Increased NLR may be useful as an indicator of the presence of HT, especially in complicated cases. NLR is inexpensive and easy to determine. Larger, prospective studies are required to determine its usefulness in assessing diagnostic potential and treatment outcomes in HT patients.

We suggest that elevated RDW values in patients without iron deficiency anemia may require further evaluation for HT, especially in female population.

Epithelioid sarcoma of vulva is an extremely rare and aggressive tumor. In most patients it is asymptomatic, and the lesions are usually mistaken for benign processes, leading to diagnosis at later stages. We report a case of vulvar epithelioid sarcoma in a 51-yr-old woman presenting with a nodularity of vulva. Left hemivulvectomy with bilateral inguinal lymph node dissection was performed. There was no evidence of distant metastasis at the time of diagnosis. Following adjuvant chemoradiotherapy and three cycles of chemotherapy, the patient developed lung metastasis 4 mo after surgery and died of disseminated disease after 6 mo of diagnosis. Vulvar epithelioid sarcoma is rare; showing different behavior changing from an extremely aggressive tumor to behaviors like low-grade tumors. It is best treated by early diagnosis and initial eradication. Definitive surgery provides excellent local control and survival in low-grade tumors. The role of adjuvant treatment remains to be determined.

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BackgroundTo determine the ocular changes related to hypothyrodism in newly diagnosed patients without orbitopathy.FindingsThirty-three patients diagnosed to have primary overt hypothyroidism were enrolled in the study. All subjects were assigned to underwent central corneal thickness (CCT), anterior chamber volume, depth and angle measurements with the Scheimpflug camera (Pentacam, Oculus) and cup to disc ratio (C/D), mean retinal thickness and mean retinal nerve fiber layer (RNFL) thickness measurements with optical coherence tomography (OCT) in addition to ophthalmological examination preceeding the replacement therapy and at the 1st, 3rd and 6th months of treatment.The mean age of the patients included in the study were 40.58 ± 1.32 years. The thyroid hormone levels return to normal levels in all patients during the follow-up period, however the mean intraocular pressure (IOP) revealed no significant change. The mean CCT was 538.05 ± 3.85 μ initially and demonstrated no statistically significant change as the anterior chamber volume, depth and angle measurements did. The mean C/D ratio was 0.29 ± 0.03 and the mean retinal thickness was 255.83 ± 19.49 μ initially and the treatment did not give rise to any significant change. The mean RNFL thickness was also stable during the control visits, so no statistically significant change was encountered.ConclusionsNeither hypothyroidism, nor its replacement therapy gave rise to any change of IOP, CCT, anterior chamber parameters, RNFL, retinal thickness and C/D ratio.