BackgroundIdiopathic granulomatous mastitis (IGM) is a benign rare inflammatory disease of the breast. Due to its uncommon etiology, diagnosis and treatment is still unknown. Selection of a standard method for diagnosing idiopathic granulomatous mastitis is sophisticated. In view of non-definitive clinical and imaging finding, histopathology is the cornerstone of definitive diagnosis.ObjectiveTo determine and help solve the dilemma of treatment and diagnosis of idiopathic granulomatous mastitis.MethodsThis historical cohort study was conducted on 48 patients who referred to the general surgery clinic of Imam Khomeini Hospital of Urmia, were diagnosed with IGM and were histopathologically selected by census using the registry system, in Urmia city, Iran, during 2010–2015 so that medical reports, ultrasonography (US) and mammography (MMG) findings, follow-up information and recurrence rate were obtained from records. The data were analyzed using SPSS software version 18 and descriptive statistics were used.ResultsAccording to records, 68.75% of patients (n=33) had palpable mass, 45.83% of patients (n=22) had breast pain and swelling, erythema and 20.83% of patients (n=10) had purulent drainage. Of the 48 patients 12 (25%) had mammography, which revealed the following findings: mass with irregular border in 6 patients, skin thickness in 2 cases (4.16%), and parenchymal asymmetry in 4 cases (8.33%). Minimum follow-up was 24 (range 24–56) months.ConclusionsAccording to our findings, histopathology of the disease is fundamental for correct diagnosis. Steroid therapy as a therapeutic method such as prednisolone was an effective and applicable choice in the treatment of idiopathic granulomatous mastitis by decreasing in inflammation.
Background. Colorectal cancer is the third most prevalent cancer worldwide, which is less common in the Middle East; its prevalence demonstrated to be 7 persons per 100,000 populations in Iran. In this study, we aimed to investigate the clinicopathologic features of CRC patients in West Azerbaijan province of Iran. Methods. In this crosssectional study, 546 patients who underwent surgical procedures with the pathologic diagnosis of colorectal cancer in both academic and private hospitals of Urmia were enrolled. Results. The mean age at diagnosis was 55.2 ± 11.5 years. 23% had an age lower than forty years old. Rectal bleeding (26%), abdominal pain (25%), and large bowel obstruction (23%) were three most common presenting symptoms. 26% of patients presented with acute abdomen. 95% of tumors were adenocarcinoma, 4% were lymphoma, and 1% was other rare tumors. Regarding the stage of cancer according to TNM staging system, 6% of patients were in stage I, followed by 37% in stage II, 33% in stage III, and 24% in stage IV. In 44.5% of patients, the tumor was located in rectum. Conclusion. In west Azerbaijan province of Iran, patients with colorectal cancer present in younger age and more advanced stages in comparison with the developed countries.
Aberrant right subclavian artery (ARSA) is a rare anomaly, in which the right subclavian artery arises directly from the aortic arch instead of originating from the brachiocephalic artery. This anomaly should be taken into consideration during surgical procedures around esophagus, such as esophagectomy. Any unintentional injury of this artery during surgical procedures could be extremely life threatening. A 56-year-old woman presented with dysphagia, with concurrent aberrant subclavian artery and esophageal cancer. The transhiatal esophagectomy was performed successfully since the anomaly was preoperatively diagnosed using computed tomography scan. The presence of ARSA during esophagectomy may be challenging, but if diagnosed preoperatively, the precise and diligent dissection of the retroesophageal space during esophagectomy, may prevent any injury to the aberrant artery and consequent complications.
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