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Merkel cell carcinoma (MCC) is an unusual skin tumor that has a significant rate of distant and local metastases. It is known that primary MCC of the eyelid usually occurs at the upper eyelid. Here we report an unusual case of MCC metastasis to the eyelid. A 63-year-old male was diagnosed with MCC three years earlier after initially presenting with a mass in his right thigh. After histopathological diagnosis, the patient received medical therapy. During treatment, he developed multiple distant metastases and a firm, purple, vascularized lesion on the upper eyelid. We confirmed the lesion was an eyelid metastasis of MCC by histopathological examination and imaging methods. This case shows that extraocular MCC can metastasize to the eyelids, particularly the upper eyelid, where primary periocular MCC usually appears. [ABSTRACT FROM AUTHOR]

Inroduction: Germline variants in CHEK2 gene have been associated with susceptibility to various cancers, especially breast and colon cancer. Although, it is known to be a gene with a moderate effective, it has been found a relationship between the type of mutations and cancer risk. For breast cancer, the odds ratio for truncating variants (eg. c.1100del, c.444+1G>A, ex8_9del) was found to be around 2.5, while for missense variants (eg. I157T, R117G, S428F, T476M) this ratio was around 1.5. Therefore, this situation should be taken into consideration when providing genetic counseling. Methods: A custom-designed germline panel was applied to 580 patients with suspected familial cancer syndromes and results were evaluated with Qiagen QCI Interprete. All CHEK2 gene variants detected in patients were collected and evaluated for mutation type and clinical significance based on Clinvar and Varsome data. Discussion: A total of 18 different variants were detected in 53 patients in the cohort (9%). The E84E variant, which is a benign variant, was the most frequently observed variant with 37 patients 6.3%. Among the truncating mutations, c.444+1G>A (1 patient) and c.592+3A>T (3 patients) were detected, while various missense variants were detected in other cases. Of these, R180C, L183F, I157T, T476M were among the variants with pathogenic/likely pathogenic records in the Clinvar database. W93R, E478Q, D438Y, K141T, H371T, K373T, R519L, R137Q, S356L, E450K mutations were registered as of uncertain clinical significance in Clinvar. E84E and T532T are benign variants detected. Conclusion: Various variants in the CHEK2 gene are frequently encountered in daily cancer genetics practice. There is no clarity in the recommendations to be made in case of detection of some variants, especially missense variants, that have been detected throughout the gene and have previously been identified as disease-causing in databases such as Clinvar and in the literature, and this makes genetic counseling quite challenging. [ABSTRACT FROM AUTHOR]

Ecotourism, which takes into account the benefits of local people while preserving the resource values of natural areas, has become one of the alternative tourism types that are attracting attention day by day in our country and in the world. Ecotourism, which emerged as a product of sustainable development and planned in rural areas, is a nature-based approach and includes many components. The concept of ecotourism, along with the concepts of rural development, sustainable development and tourism, has taken its place in upper-scale plans and policy approaches. This situation is also reflected in academic studies. In this context, in the study; In order to be able to deal with all aspects of ecotourism, eight main headings were determined as ecotourism, ecotourism planning, ecotourism management, nature tourism, sustainable tourism, rapid rural assessment, ecological planning and sustainable development, and a general evaluation of academic studies on these subjects was made. Quantitative analysis of articles and postgraduate theses written between 2000 and 2022 in the Scopus Database and YÖK Thesis Center databases on related subjects was made. In the evaluations made; "ecotourism, ecotourism planning, ecotourism management, nature tourism, sustainable tourism, rapid rural assessment, ecological planning and 23196 articles on the subject of "sustainable development" were reached in the Scopus database. In the database of YÖK Thesis Center, a total of 556 theses, 111 of which are doctoral and 445 master's, were reached. As a result of the research, it was determined that the studies on related subjects varied according to years, subjects and departments; It has been determined that the area with the most articles and theses is sustainable development, and the area with the least number of articles and theses is the rapid rural evaluation area. With the study, the development situation experienced since 2000 in the fields of "ecotourism, ecotourism planning, ecotourism management, nature tourism, sustainable tourism, rapid rural assessment, ecological planning, sustainable development" has been revealed and a contribution has been made for national and international studies. [ABSTRACT FROM AUTHOR]