Ectopic thyroid tissue has been found in the developmental pathway of the thyroid gland and has also been reported in the abdominal cavity. Intra-abdominal thyroid tissue was totally resected around the mesentery of the small intestine in a 56-year-old woman. She had hyperthyroidism preoperatively and had also undergone a bilateral subtotal thyroidectomy 10 years earlier. No signs or symptoms of a thyroid tumor were present.
BackgroundBecause there may be interdepartmental differences in macroscopic sampling of cholecystectomy specimens, we aimed to investigate differences between the longitudinal sampling technique and our classical sampling technique in cholecystectomy specimens in which there was no obvious malignancy.MethodsSix hundred eight cholecystectomy specimens that were collected between 2011 and 2012 were included in this study. The first group included 273 specimens for which one sample was taken from each of the fundus, body, and neck regions (our classical technique). The second group included 335 specimens for which samples taken from the neck region and lengthwise from the fundus toward the neck were placed together in one cassette (longitudinal sampling). The Pearson chi-square, Fisher exact, and ANOVA tests were used and differences were considered significant at p<.05.ResultsIn the statistical analysis, although gallbladders in the first group were bigger, the average length of the samples taken in the second group was greater. Inflammatory cells, pyloric metaplasia, intestinal metaplasia, low grade dysplasia, and invasive carcinoma were seen more often in the second group.ConclusionsIn our study, the use of a longitudinal sampling technique enabled us to examine a longer mucosa and to detect more mucosal lesions than did our classical technique. Thus, longitudinal sampling can be an effective technique in detecting preinvasive lesions.
Recent studies report that tumor microenvironment effects prognosis of colorectal cancers. We analyzed the densities of FoxP3+ cells and CD8+ cells, the ratio of FoxP3+/CD8+ cells and the relationship between these parameters, clinicopathological features, and prognosis. A total of 186 colorectal adenocarcinoma were evaluated in terms of clinicopathological features. Immunohistochemically, densities of intratumoral (IT; IT-FoxP3) and nontumoral (NT; NT-FoxP3) FoxP3+ cells and IT-CD8 and NT-CD8 CD8+ cells were calculated. The ratio of Foxp3/CD8 was recorded. IT-FoxP3 and the ratio of IT-FoxP3/IT-CD8 were higher than NT-FoxP3 and the ratio of NT-FoxP3/NT-CD8, respectively. In multivariate analysis, high FoxP3+ cell density is the most important predictive marker after clinical stage and surgical margin positivity in disease-free survival and the most important predictive marker after clinical stage in overall survival (OS). Short OS time was correlated with clinical stage, decrease in IT-FoxP3, increasing age, number of metastatic lymph nodes, surgical margin positivity, satellite tumor nodule, medullary carcinoma, and the number of pericolorectal lymph nodes. The ratio of FoxP3/CD8 increased noticeably in the IT area, but no relationship was found with survival. The relationships of the cells with one another in the tumor microenvironment seem to have many secrets. Studies in large series supported by molecular techniques can illuminate those secrets to some extent.
Gallbladder cancers (GBC) are characterized by rapid progression, early metastasis, and poor prognosis; the molecular mechanisms of the various signaling pathways involved should be elucidated to develop effective therapies. Survivin, an apoptosis inhibitor protein expressed in the G2/M phase of the cell cycle, plays a role in cell division and affects both cell survival and proliferation. Survivin has been investigated in many types of cancer, and this study aims to examine the relationship of survivin expression in gallbladder cancer patients with clinicopathological features and prognosis. We evaluated demographic characteristics (age, gender), tumor characteristics (histopathological type, differentiation, perineural, and lymphovascular invasion; serosal invasion, surgical margin positivity and lymphocytic response), and Survivin expression immunohistochemically, and we analysed the relationship between these characteristics and prognosis in 47 gallbladder carcinoma cases from 2000 to 2011. Immunohistochemically, while survivin expression was observed in 36 cases, it was absent in 11 cases. Follow-up data were obtained from 32 patients. Two (8.7%) of 23 cases with a Survivin-positive tumor were alive at 74th and 35th months, whereas 5 (%55.6) of nine cases with Survivin-negative tumor were alive at 50th, 89th, 124th, 126th, 131th months. Survivin expression was correlated with short survival (p = 0.043), and the univariate analysis showed that reduced overall survival was associated with age (p = 0.043), male gender (p = 0.038), infiltrative pattern (p = 0.019), lymphovascular invasion (p = 0.004), perineural invasion (p = 0.009), serosal invasion (p = 0.027), ulcer (p = 0.033), and surgical margin positivity (p = 0.022). Despite the low number of patients in our study, the analysis results suggest that survivin positivity might actually be a significant prognostic factor. This finding could be a reference point for targeted treatment studies. However, further studies involving broader series and longer follow-up are still required for highly lethal gallbladder cancers.
In this case study, we present an unusual case with squamous cell carcinoma originating from a giant condyloma acuminata completely surrounding the penis. A 57-year-old circumcised heterosexual male patient presented with a penile lesion existing for 20 years. Incisional biopsy revealed acanthosis of the squamous epithelium. The patient was operated on under spinal anaesthesia. The lesion was resected circumferentially with macroscopic clearance, resulting in complete degloving of the penile shaft. Neurovascular bundles were preserved. The penile skin was constructed with a split thickness skin graft. Histopathological analysis of the lesion revealed an invasive and well-differentiated squamous cell carcinoma arising on a condyloma, and the surgical margins were free from tumour. The patient was staged as G2 T1 N0 M0 and was followed for one year. He did not have any erectile dysfunction and could engage in intercourse. Pelvic tomographic and physical examination findings did not reveal any episode of recurrence or metastasis. When encountering patients with giant condyloma acuminata, it should not be forgotten that it may be accompanied by squamous cell carcinoma. In addition, tissue excision should be as extensive as possible while keeping in mind the importance of the function. This is the first case of a penile-degloving surgery for giant penile condyloma, supporting conservative and preserving penile surgery for such tumours.
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