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Arteriovenous malformations (AVMs) entail direct connections between arteries and veins. Uterine AVMs, in particular, are rare gynecologic vascular pathologies that can manifest either asymptomatically or with life-threatening bleeding. They may arise congenitally or, more commonly, post-myometrial trauma. While Doppler ultrasonography serves as the primary diagnostic tool today, computed tomography, magnetic resonance imaging, or angiography may also be employed. Treatment selection should be tailored to each patient, considering symptoms and fertility expectations. For patients desiring fertility, monitoring, medical therapy, or angiographic interventions are favored, whereas for those without fertility expectations, advanced age, and symptomatic disease, surgery emerges as the definitive treatment. In our case, a 45-year-old woman with a history of one previous cesarean section presented with prolonged and uncomfortable vaginal bleeding and no fertility expectations. She underwent a total laparoscopic hysterectomy and bilateral salpingooophorectomy, oophorectomy was performed according to the patient's request. [ABSTRACT FROM AUTHOR]

Aims: Our research aims to shed light on the connection between histopathological differences that affect the prognosis of endometrial cancer and Doppler indices measured in the uterine arteries. Methods: Seventy‐four women with a confirmed diagnosis of endometrial cancer participated in this prospective study. The flow characteristics of the bilateral uterine arteries were evaluated and recorded using color Doppler sonography. After hysterectomy, a correlation analysis was performed between these factors and histological findings. Results: Patients who complained of menometrorrhagia had significantly higher uterine artery peak systolic flow (p = 0.020) than those who had postmenopausal vaginal bleeding. Endometrioid adenocarcinoma was the most common type (71.4%). Doppler pulsatility index and resistance index in the uterine arteries didn't show statistically significant differences between histologic subtypes, tumor grade, myometrial invasion, lymphovascular invasion, lymph node involvement, malignant peritoneal cytology, genetic mutation, or extrauterine involvement. Those without cervical involvement had higher uterine artery Doppler peak systolic flow/end diastolic flow (p = 0.024). Conclusions: Endometrial cancer made uterine artery, myometrium and endometrium less resistant to blood flow. However, these blood flow indices have not been standardized enough to be utilized as diagnostic tests just yet. Standardization based on more advanced studies would make it possible to use ultrasonography for non‐invasive diagnosis and would accelerate and facilitate clinical management. [ABSTRACT FROM AUTHOR]

Purpose: The present study aimed to analyze and compare sonographic features of papillary thyroid carcinoma (PTC) subtypes to determine whether ultrasound (US) may aid in differentiating particular subtypes. Methods: This retrospective study enrolled 133 patients diagnosed with 142 histopathologically proven PTCs as per the fifth edition of the World Health Organization classification of thyroid neoplasms between January 2013 and May 2023. US features based on the American College of Radiology and European Thyroid Imaging and Reporting Data Systems (TIRADS), and histopathological characteristics of nodules were assessed and compared. Results: Histopathological analysis yielded 55 (38.7%) classic PTC, 32 (22.5%) invasive encapsulated follicular variant (IEFV) PTC, 20 (14.1%) oncocytic subtype, 14 (9.9%) non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP), 11 (7.8%) infiltrative follicular subtype, 7 (4.9%) tall cell subtype, 2 (1.4%) solid subtype, and 1 (0.7%) diffuse sclerosing subtype. The US findings indicating malignancy, such as taller-than-wide shape, irregular margins, echogenic foci, and higher TIRADS categories, were more frequently demonstrated in nodules with classic PTC and the tall cell subtype, in line with their histopathological features. Conversely, IEFV-PTC and NIFTP rarely exhibited these high-risk sonographic features. US appearance of the oncocytic subtype more frequently overlapped with IEFV-PTC, yet hypo/very hypoechoic nodules with larger nodular diameters and higher TIRADS scores may favor the diagnosis of this subtype. Conclusion: US features of certain subtypes may guide the differential diagnosis regarding shape, margin, echogenic foci, and TIRADS category of nodules; however, definitive subtyping is not yet possible using US images alone. [ABSTRACT FROM AUTHOR]

We aimed to evaluate the incidental risk of malignancy in mature cystic teratomas (MCT) and check the management. We retrospectively reviewed records of patients diagnosed and treated with MCT and divided patients into two groups as pure MCT and malignant transformation of MCT. In our clinic incidence of incidental malignant transformation of ovarian MCTs was 2.7%. Median age (p = 0.005) and mass size (p = 0.027) were statistically higher in malignant group. The most common histological type of malignant transformations was malignant struma ovarii (35.7%). In malignant group, five-year disease-free survival was 66.7% and five-year overall survival was 86.7%. Although the risk of malignancy in mature cystic teratomas is rare, it should not be ignored. Age, mass size, and preoperative imaging should all be evaluated with suspicion and if available, frozen section should be used. Management is inconsistent as a result of its rarity. New management practices should be developed with further studies. [ABSTRACT FROM AUTHOR]

Vascular tumors are rare in the breasts, and the most common forms include hemangiomas and angiosarcomas. Hemangiomas are rare benign vascular tumors. Most of them are asymptomatic and nonpalpable clinically, and the vast majority of such lesions are detected incidentally by mammography. Breast hemangiomas are difficult to diagnose using conventional imaging modalities since their imaging findings are variable. The following is a case presentation of an asymptomatic forty-five-year old female patient who was diagnosed with a rare hemangioma. Physical examination, ultrasonography (US) and mammographic examination were normal. Dynamic contrast enhanced magnetic resonance imaging (MRI) showed a non-mass pathological enhancement. After a short-term follow up, a comparative MRI was obtained and biopsy was planned, due to the heterogeneous non-mass enhancement on MRI. Needle core biopsy with US guidance was performed, resulting in benign findings. However, because of the discordance between imaging and histopathology, an MRI-guided wire localization followed by open surgical biopsy was performed. Histopathologic evaluation reported capillary hemangioma. The imaging findings, including US, mammography and MRI, of hemangioma are reviewed and described in this case report. [ABSTRACT FROM AUTHOR]

Objective: Minor salivary gland biopsy is one of the objective tests used in the diagnosis of Sjögren syndrome. The aim of our study was to compare the clinical and laboratory data of primary and secondary Sjögren syndrome cases with a lymphocyte score 3 and 4 in the minor salivary gland biopsy. Material and Method: Data from a total of 2346 consecutive minor salivary gland biopsies were retrospectively evaluated in this study. Clinical and autoantibody characteristics of 367 cases with lymphocyte score 3 or 4 and diagnosed with primary or secondary Sjögren syndrome were compared. Results: There was no difference between lymphocyte score 3 and 4 primary Sjögren syndrome patients in terms of dry mouth, dry eye symptoms and Schirmer test results but Anti-Ro and Antinuclear Antibody positivity was statistically significantly higher in cases with lymphocyte score 4 (p= 0.025, p= 0.001). Anti-Ro test results were also found to be statistically significantly higher in secondary Sjögren syndrome patients with lymphocyte score 4 (p= 0.048). Conclusion: In this study, the high proportion of cases with negative autoantibody but positive lymphocyte score is significant in terms of showing the contribution of minor salivary gland biopsy to Sjögren syndrome diagnosis. Lymphocyte score 3 and 4 cases were found to have similar clinical findings but a difference regarding antibody positivity in primary Sjögren syndrome. We believe that cases with lymphocyte score 4 may be Sjögren syndrome cases whose clinical manifestations are relatively established and higher autoantibody levels are therefore found. [ABSTRACT FROM AUTHOR]

Environmental pollutants such as organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs), so called persistent organic pollutants (POPs) have been known to interfere various ion channels in organism, which is the main mechanism of action especially for OCPs. Furthermore, all PCBs and several congeners of OCPs and PBDEs were recently listed as "carcinogen" by the IARC depending on evaluation of epidemiological studies. On the other hand, there have been very little data on the relation between various cancers and tissue burden of these toxicants. In majority of the human studies on a possible association between POPs and cancers, exposure data have been based on statement-based interviews, which potentially impair the accuracy and reliability of quantitative assessment. In order to accurately assess whether environmental exposure to POPs increase risk of kidney, stomach and breast cancers, tumour tissues as well as blood and urines were collected from surgically operated patients. Cellular DNA and protein oxidative damage markers (8-OHdG and dityrosine, respectively), have also been analysed in the patient and healthy control groups, and assessed whether there are changes in these parameters. The data suggest that majority of POPs in cancerous tissues were associated with cancers in patients, while they are less conclusive in blood of the same patients. DNA and protein damage markers were found to be higher in urines of kidney cancer patients compared to healthy volunteers, although inter-individual variability obscured statistical significances. Current findings confirmed that glutathione S-transferase theta1 (GSTT1) nullpolymorphism is a risk factor Bforro ukgidhnte tyo cyaonuc ebry, |a nEdP cIyptsowchicrohme P450 1A1 (CYP1A1) is a risk factor for stomach cancer. Data suggest that environmental exposure to POPs may induce tumour initiation and/or progression in humans however, blood concentrations of the same pollutants do not adequately reflect tissue concentrations except dichlorodiphenyldichloroethylene (DDE), the major metabolite of the notorious organochlorine pesticide dichlorodiphenyltrichloroethylene (DDT). Possible role of interaction of POPs with ion channels in cancer initiation and/or progression remain to be explored. [ABSTRACT FROM AUTHOR]

The lung is the most common site of metastasis for many malignancies. Especially the gastrointestinal system, gynecological malignancies and osteosarcomas frequently metastasize to the lung. It accounts for less than 0.5% of all ovarian neoplasms. The frequency of recurrence and metastasis is less than 5%. In most cases, they are stage I tumors, limited to the ovary and carry a good prognosis. Here, while investigating the nodules in the lung that were detected incidentally at the age of 64, the rare Sertoli-Leydig cell tumor of the lung is discussed clinically, radiologically and pathologically in the presence of a 64-year-old patient who was found to have undergone ovarian surgery 9 years ago. Since imaging methods and tumor markers did not yield significant results in terms of primary malignancy, wedge resection was performed from the left lung nodules. The histology of the lung nodule was the same as the poorly differentiated foci of the ovarian tumor. The immunohistochemical profiles of the two tumors were also similar. As a result of the evaluation of the patient's old materials belonging to the ovary and the samples taken from the lung together; The diagnosis was reached by obtaining similar results with the primary tumor in the immunohistochemical examination performed for the metastatic focus. Sex cord stromal tumors of the ovary, which rarely cause lung metastasis and have a tendency to recur and metastasis in a very long time after the first diagnosis, should also be kept in mind in the elderly woman and the patient with a gynecological history.

Primary rhabdomyosarcoma is one of the malignant soft tissue sarcomas of childhood originating from embryonic mesenchyme. The tumor can occur in the head, neck region, and limbs, and genitourinary system. Primary ovarian rhabdomyosarcoma is an extremely rare malignancy with a few documented pediatric patients in the literature. Pseudo-Meigs' syndrome is a type of Meigs' syndrome that is usually associated with other benign ovarian tumors or any other type of malignant tumors. It is a rare condition characterized by ascites, pleural effusion, benign ovarian tumors or fibroma-like tumors, and resolution of ascites and pleural effusion after the removal of the tumor. A patient of Asian origin came to our clinic with symptoms of mild dyspnea, and gradually increasing abdominal swelling. Magnetic resonance imaging scans indicated masses with solid cystic components on both ovaries with a suspicion of malignancy, showing bilateral pleural effusion and massive ascites. This is the first reported case of a pure primary ovarian rhabdomyosarcoma associated with a Pseudo-Meigs syndrome in a young girl., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (Copyright: © 2020 Turkish Archives of Pediatrics.)

Gastrointestinal malignant melanomas, either primary or metastatic, are rare and overlooked tumors. There is also controversy regarding the actual existence of primary melanoma in the gastrointestinal tract apart from the esophagus and anorectal regions, where melanocytes normally exist. A case of malignant melanoma in the cecum is presented. The patient was a 30- year-old male who presented to the hospital for abdominal pain and diarrhea. The tumor was located mainly in the submucosa and measured 14x11x4.5 cm. The cut surface was solid, gray-white and fleshy. Histologically, tumor cells were arranged in compact nests or wide cords surrounded by fibrous stroma. The tumor cells had pleomorphic nuclei and quite rich cytoplasm; multinucleated, giant tumor cells were intermingled. Although no tumor cells contained apparent brown pigment, most were found to be positive for S-100 protein, HMB-45, Melan-A, and vimentin. The possibility of a metastatic lesion was considered. While the patient had a history of a pathologically examined dorsal nevus excision two years before, there was no evidence of either cutaneous or ocular primary melanoma at the time of diagnosis. Moreover, a thorough postoperative investigation did not reveal any other lesion in any other site favoring a metastatic spread. There was also no evidence of recurrent disease or metastasis one year after the surgery. This case is presented in view of its rare occurrence in the cecum. The difficulties in the diagnostic course are discussed, together with a literature review on distinguishing a primary mucosal melanoma from a metastatic one from an unknown or regressed cutaneous primary tumor.

There are a fair number of polyps in the gastrointestinal tract, which cannot be classified under a certain category. We report herein a 50-year-old man with a 6-mm sigmoidal polyp; he had been operated previously for rectal carcinoma. The polyp was characterized by benign-appearing spindle cells in the lamina propria leading to a wide separation and disorganization of the colonic crypts, accompanied by focal erosion and restricted areas suspicious for inflammatory fibroid polyp. The histologic features were found consistent with the disease spectrum of 'benign fibroblastic polyp of the colon' defined by Eslami-Varzaneh et al. The case is presented with a review of the literature and differential diagnostic considerations.