ÖZSistemik amiloidozis, Ailesel Akdeniz Ateşinin (FMF) ciddi komplikasyonlarından biridir. Tiroid bezinde, FMF' e sekonder ve bası semptomu oluşturacak düzeyde amiloid birikimi nadir görülen bir durumdur. FMF tanısıyla takip edilen 17 yaşında erkek hasta, boyun ön tarafında son 3 aydır hızlı büyüyen şişlik ve nefes darlığı şikayeti ile genel cerrahi polikliniğine başvurdu. Yapılan tetkiklerinde tiroid bezinde bası oluşturan, diff üz hiperplazi tespit edilmesi nedeniyle total tiroidektomi yapıldı.Total tiroidektomi materyalinin histopatolojik incelemesinde parankim içerisinde follikülleri basıya uğratan, yoğun amiloid birikimi ve diff üz yağ infiltrasyonu ile birlikte tiroid dokusunda kistik alanlar görüldü. Kistlerin epitelinde skuamöz metaplazi odakları tespit edildi. Bu bulgulara göre olguya metaplazik değişikliklerin eşlik ettiği amiloid guatr tanısı konuldu. Sonuç olarak uzun süredir FMF'i olan hastalarda amiloid guatr'a metaplazik değişikliklerin de eşlik edebileceğini göz önünde bulundurulmalıdır.Anahtar Sözcükler: Amiloid, Tiroid hastalıkları, Ailesel Akdeniz ateşi ABSTRACTSystemic amyloidosis is one of the serious complications of Familial Mediterranean Fever (FMF). Amyloid accumulation secondary to FMF can cause pressure symptoms in thyroid gland rarely. A 17-year-old male patient with the diagnosis of FMF performed the complaints of dyspnea during his follow-up period. He has demonstrated a rapidly increasing mass localized in front of his neck within the last three months that was diagnosed as a diff use, hyperplasic and pressuring thyroid gland. Total thyroidectomy was performed.Histopathological investigation of the material obtained aft er thyroidectomy revealed diff use lipid infiltration in parenchyma, intense amyloid accumulation around and between the follicles that caused pressure on the follicles, and cystic areas in the tissue. Squamous metaplasia foci in cyst epithelium were detected. Upon these findings the case was diagnosed as amyloid goiter accompanied by metaplastic variations. In conclusion, it can be appropriate to take into account the possibility that metaplastic variations could accompany amyloid goiter in patients with long-term FMF.

Objectives: In this study, we examined the value of prostate specific antigen (PSA) and digital rectal examination (DRE) in prostate cancer detection among men.Materials and methods: Between January 2006 and July 2011, transrectal prostate needle biopsy was performed in 349 patients with abnormal DRE and/or >4ng/ml serum total PSA level were involved in the study. According to the histopathological examination, the patients were divided into two groups as without and with prostate cancer and their data were compared.Results: At the end of the histopathological examination, 121 (32.4%) cases had prostate cancer and 252 (67.6%) cases found without prostate cancer. Mean age and mean PSA values were higher and prostate volume was lower in the prostate cancer group than the other group. Prostate cancer was detected in 73 of the patients (66.4%) whose DRE was abnormal. In prostate cancer group, Gleason scores of 47 patients' (38.8%) were "6", Gleason scores of 42 patients' (34.7%) were " 7" and Gleason scores of 32 patients' (26.5%) were between 8 and 10. Positive predictive values for high serum total PSA level (>4 ng/ml) and abnormal DRE were found as 39.7% and 66.4% respectively. Conclusions:Only serum total PSA measurement or only DRE is inadequate differential methods for differentiation of benign and malign prostate diseases. When DRE was assessed with serum total PSA level, cancer detection rate and reliability increases. J Clin Exp Invest 2012; 3(1): 66-70

Introduction: Primary apocrine sweat gland adenocarcinoma is a very rare tumour. Apocrin carcinoma is a high incicence of local recurrence and lymph node metastasis. When the location of the tumor is axilla, it should be differentiated from occult breast cancer. Surgery is the first step in primary apocrine cancer treatment. However, there is no clear consensus about adjuvant part of treatment.Methods: The case with axillary apocrin carcinoma was presentated diagnosis, differential diagnosis and treatment approach.Result : Axillary localized apocrine carcinoma was differentiated from occult breast cancer by pathological findings. For this reason, the patient was operated only an axillary dissection operation. Operated patient with axillary apocrine carcinoma was treated with radiotherapy. As a result of pathological evaluation of the tumor, tamoxifen was added to the treatment when the hormone receptor was positive.Conclusions: The patient with apocrine carcinoma was treated with sequential radiotherapy and tamoxifen, and disease-free follow-up to this day

Background: Primary apocrine sweat gland adenocarcinoma is a very rare tumor. Apocrine carcinoma is a high incidence of local recurrence and lymph node metastasis. When the location of the tumor is axilla, it should be differentiated from occult breast cancer. Surgery is the first step in primary apocrine cancer treatment. However, there is no clear consensus about adjuvant part of treatment. In this case, we presented a 60-year old female patient with primary apocrine sweat gland carcinoma of the axilla. To our knowledge, this is the first case in the literature to use combined adjuvant radiation therapy and anti-estrogen therapy.Case presentation: A 60-year old female patient presented with a slowly growing mass in the right axilla. The patient was examined by a surgeon and there was suspected to be metastasis from breast cancer diagnosed in September 2017. Axillary localized apocrine carcinoma was differentiated from occult breast cancer by pathological findings. For this reason, the patient was operated only an axillary dissection operation. Operated patient with axillary apocrine carcinoma was treated with radiotherapy. As a result of pathological evaluation of the tumor, tamoxifen was added to the treatment when the hormone receptor was positive.Conclusions: The pathological features must be evaluated in detail for targeted treatment, which should be ap-plied with a multidisciplinary approach. Based on this case presentation and literature, adjuvant radiotherapy can be recommended to reduce the risk of local recurrence and hormone-therapy to reduce distant recurrence in patients with hormone-receptor positive primary apocrine carcinoma.