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Linear scleroderma is a rare variant of localized scleroderma typically seen in children and localized in the extremities. A 21-year-old female patient had a well-defined, hyper-pigmented, sclerotic plaque on right half of the frontal trunk, starting from the breast and arcing up to the right arm, then continuing linearly with anti-nuclear antibody positivity in her laboratory results. Histopathology was compatible with scleroderma. She was diagnosed linear scleroderma. There is an ongoing argument on whether localized scleroderma follows Blaschko's lines or not. By presenting this case, we aimed to contribute to literature claiming that localized scleroderma may follow Blaschko's lines. © 2012 Düzce Medical Journal.

Lineer skleroderma lokalize sklerodermanın nadir bir varyantıdır, tipik olarak çocuklarda görülür ve ekstremite yerleşimlidir. 21 yaşında bayan hastanın gövdesinin sağ üst yarısında meme üzerinden başlayıp ark çizerek sağ kola uzanan ve sonra lineer devam eden belirgin sınırlı, hiperpigmente, sklerotik bir plağı vardı ve antinükleer antikoru pozitifti. Histopatolojisi skleroderma ile uyumlu idi. Hastaya lineer skleroderma tanısı konuldu. Lokalize sklerodermanın Blaşko çizgisini takip edip etmediği tartışmalı bir konudur. Bu vakayı sunmakla lokalize sklerodermanın Blaşko çizgilerini takip edebileceğini düşünerek literatüre katkıda bulunmayı amaçladık. Linear scleroderma is a rare variant of localized scleroderma typically seen in children and localized in the extremities. A 21-year-old female patient had a well-defined, hyper-pigmented, sclerotic plaque on right half of the frontal trunk, starting from the breast and arcing up to the right arm, then continuing linearly with anti-nuclear antibody positivity in her laboratory results. Histopathology was compatible with scleroderma. She was diagnosed linear scleroderma. There is an ongoing argument on whether localized scleroderma follows Blaschkos lines or not. By presenting this case, we aimed to contribute to literature claiming that localized scleroderma may follow Blaschkos lines.

Synovial sarcoma (SS) is a type of soft-tissue sarcoma, often linked to poor survival. Although overexpression of enhancer of zeste homologue 2 (EZH2) has been associated with poor prognosis in different tumors, a few studies investigated this link in SS. Here, we analyzed the relationship between EZH2 expression and prognostic factors in SS. We included 29 patients with SS. Immunostaining of EZH2 was performed with (D2C9) XPTM Rabbit mAb antibody, and the results were classified as low EZH2 expression (negative or weak expression) and high EZH2 expression category (moderate or strong expression). Analysis of survival in relation to prognostic factors was performed with Kaplan-Meier survival curves and Cox proportional hazard regression analysis. Our sample included 19/29 female and 10/29 male patients, with age range 16-63 years. The tumor diameter ranged from 2 to 15 cm. Necrosis was observed in 15/29 cases. Sixteen cases had >10 mitoses per 50 high-power fields (HPFs). Out of 29 cases, 14 showed low and 15 had high EZH2 expression. Statistically significant results were obtained for the association between the presence of metastasis and necrosis (p = 0.042), high EZH2 expression and distant metastasis (p = 0.018), high EZH2 expression and necrosis (p = 0.016), and high EZH2 expression and the tumor size >5 cm versus tumor size ≤5 cm (p = 0.014). Patients with all of the following: the tumor size ≤5 cm, low EZH2 expression, and without necrosis and distant metastasis had significantly longer survival time. Our results are consistent with previous studies, suggesting that EZH2 overexpression is an indicator of poor prognosis in SS.

OBJECTIVES: In the present study, we aimed to deterimine the dose-related effects of ticagrelor, the first reversible inhibitor of the P2Y(12) receptor, found in smooth muscle cells as well as platelets, during neointimal hyperplasia in a rabbit carotid anastomosis model. METHODS: This study was an experimental, prospective, randomized controlled study including 20 New Zealand white female rabbits (6-months old; weighing 2300 +/- 300 g). Under general anaesthesia, the rabbits underwent transection of the right carotid artery and subsequent anastomosis of both ends. The study animals were divided into the following 4 groups: T1 (ticagrelor 5 mg/kg, orally, daily), T2 (ticagrelor 10 mg/kg, orally, daily), T3 (ticagrelor 20 mg/kg, orally, daily) and control (no ticagrelor treatment). The single oral doses were administered in phosphate-buffered saline. The control group received sterile phosphate-buffered saline (2 ml/kg/day, orally) for 3 weeks postoperatively. At the end of the study, the animals were killed, and the anastomosed segment of the right carotid artery and part of the left carotid artery were excised from each animal. Antibodies against transforming growth factor-beta were used in staining of arterial sections, which was followed by histomorphological and immunohistochemical studies. RESULTS: The median intimal thickness (2.0 +/- 0.14 m left vs 73.4 +/- 35.8 m anastomosed right arteries; P

Bu çalışmada fibromatozis tanısı almış olguların dağılımı ve patolojik özelliklerinin değerlendirilmesi amaçlanmıştır. Bu çalışma, retrospektif kesitsel bir araştırmadır. Bu araştırmada, Ocak 2005 tarihi ile Aralık 2011 tarihleri arasında Uludağ Üniversitesi Tıp Fakültesi Patoloji Anabilim Dalı’nda fibromatozis tanısı almış 125 olgu değerlendirilmiştir. Hastaların yaş, cinsiyet, tümör lokalizasyonu, tümör çapı ve rekürrens bilgileri tıbbi dosyalarından ve patoloji kayıtlarından elde edilmiştir. Yüzeyel fibromatozislerin 84’ü palmar, 6’sı plantar, derin fibromatozislerin ise 25’si ekstraabdominal, 6’sı abdominal, 4’ü intraabdominal fibromatozis olgusundan oluşmaktadır. Tüm hastaların yaş ortalaması 50.4±17.4 yıldır. Palmar fibromatozisli 84 olgunun 43’ü 5. ve 6. dekatlarda saptanmıştır. Derin fibromatozisli olguların yaş ortalaması 34.2±14.9’dır. Yüzeyel fibromatozislerde ortalama tümör çapı 3.4±1.5 cm iken derin fibromatozislerde 8.8±5.4 cm ölçülmüştür. Rekürrens oranı palmar fibromatozisli olgularda %14.3, plantar fibromatozisli olgularda %20, derin yerleşimli olgularda %25.7 olarak bulunmuştur. Çalışmamızda olgu serimizin epidemiyolojik ve klinikopatolojik özellikleri genel olarak literatür ile uyumlu bulunmuştur. Yüzeyel fibromatozis olgularında diabetin, derin fibromatozisde ise travmanın sıklıkla karşılaşılan komorbiditeler olduğu görülmüştür. Serimizdeki takip süresinin (7 yıl) kısa olmasına rağmen, rekürrense sık rastlanıldığı ve özellikle derin fibromatozis nedeniyle cerrahi geçirenlerde daha fazla olduğu saptanmıştır. The aim of this study was to assess clinical characteristics and pathological features of patients diagnosed with fibromatosis. This study was a retrospective cohort study. Hematoxylin-eosin stained sections of materials of 125 cases with diagnosis of fibromatosis were reassessed. Medical records and pathology reports of patients were evaluated according to patients’ age, gender, tumor localization, tumor diameter and reccurence. In superficial fibromatoses, 84 cases were at palmar and 6 cases were at plantar localization. Furthermore, in deep fibromatoses, 6 cases were at abdominal, 4 were at intraabdominal, and 25 were at extraabdominal localization. The mean age of the patients was 50.4±17.4 years. Eighty (64%) of the cases were male and 45 (36%) were female. Male-to-female ratio was 1.7. Mean tumor diameter in superficial fibromatosis was significantly smaller than patients with deep fibromatosis (3.4±1.5 vs. 8.8±5.4 cm). Recurrence rate was higher 14,3% in cases with deep fibromatosis compared to superficial fibromatosis (25.7% vs. 38 14.4%). Our series demonstrated the similar epidemiologic and clinicopathologic features with the literatüre. We determined that diabetes and trauma are frequent comorbidites for superficial and deep fibromatosis in our series. Although, follow-up period (7 years) was short, recurrence rate was high, particularly in deep fibromatoses.

Introduction: Hyperbaric oxygen and platelet-rich plasma are used in the treatment of diabetic wounds. The aim of this study is to evaluate the effects of hyperbaric oxygen therapy and autologous platelet concentrates in healing diabetic wounds. Material and methods: Thirty-six female Wistar albino rats were used in this study. Diabetes mellitus was induced chemically with an intraperitoneal injection of streptozotocin. The rats were divided into a control group, a hyperbaric oxygen group, a platelet-rich plasma group, and a combined therapy group. Platelet-rich plasma was applied just after the creation of the wound; hyperbaric oxygen treatment was carried out daily over 7 days. Wound healing was evaluated according to four parameters: ulcerations, epidermal thickness, density of dermal collagen fibers, and proliferation of dermal blood vessels. Results: The number of active ulcers in the combined therapy group was fewer than in the control group (p = 0.039), and the wound area was greatest in controls (p < 0.001). The epidermal thickness in platelet-rich plasma and combined therapy groups was non-significantly greater than in the control group (p = 0.097 and p = 0.074, respectively). The amount of fibrous collagen in these two groups was greater than in the control group (p = 0.002). Conclusions: Combined hyperbaric oxygen and platelet-rich plasma therapy was found to be successful in diabetic wound healing. The combination therapy had no additive effect in terms of angiogenesis and the development of new collagen fibers. © 2016 Termedia & Banach.

Most of the orbital osteomas arise from the adjacent paranasal sinuses. Some of them may contain osteoblastoma-like areas and may be misdiagnosed as osteoblastoma, both radiologically as well as histopathologically. Sino-orbital osteomas with osteoblastoma-like features show a typical radiological appearance. They have a distinct zonal pattern, in which less dense osteoblastoma-like areas are located at the base of the lesion and dense mature bone is located at the periphery. These broad-based bone lesions also have a tendency for extracavitary polypoid growths from the paranasal sinus into the adjacent orbit. We report here the CT and MR imaging findings of three cases with sino-orbital osteoma with osteoblastoma-like features.

We present a case of a 44-year-old woman with an unusual location of a brown tumor in the sacral vertebrae due to parathyroid adenoma. She was admitted to our clinic with the complaint of low-back pain and was later diagnosed to have a brown tumor. The patient underwent surgery and partial sacrectomy and iliac wing resection was performed in Orthopedic Surgery Department. Subsequently the patient underwent parathyroid adenoma excision in General Surgery Department. On her control examination at postoperative 3 months, she had no pain and was able to perform daily activities without any problem. We believe it is an interesting clinical case both because it shows a very rare localization of brown tumor and points out the importance of employing a wide clinical scope in the differential diagnosis of back pain.

Osteoid osteoma and osteoblastoma are histologically similar, benign bone-forming tumors. In this retrospective study, we aimed to evaluate the natural history; clinical, pathologic, and radiologic findings; and treatment results in 204 patients between 1959 and 2006 in a single institution. According to the World Health Organization's definition, tumors = 2 cm, as osteoblastoma. For tumors between 1 cm and 2 cm, other criteria, such as the bone involved, the site, the presence of a nidus, and presence of peripheral sclerosis, were used for diagnosis. There were 131 patients with osteoid osteoma (93 male, 38 female) and 73 patients with osteoblastoma (40 male, 33 female). The mean age in the osteoid osteoma and osteoblastoma groups was 16.4 +/- 7 and 19.6 +/- 9.9 years, respectively. The osteoid osteoma cases were mostly localized in the extremities, whereas the osteoblastoma cases involved the vertebral column and sacrum. The nidus size varied between 0.2 and 1.5 cm in osteoid osteoma cases, and the tumor size range was 1.3-10 cm in the osteoblastoma cases. The pain was encountered in 89% of osteoid osteoma and 45% of osteoblastoma patients. Histopathology was similar in both cases. The treatment of choice was conservative surgery for both diagnoses. In conclusion, osteoblastoma is clinically and radiologically more aggressive than osteoid osteoma.

Background: Liposarcomas are among the most common soft tissue sarcomas in adulthood. Aim: The purpose of the study is to perform a histopathologic typing according to World Health Organization (WHO) classification of cases diagnosed with liposarcoma and to examine the difference of p53 and MDM2 expressions. Materials and Methods: The haematoxylin-eosin stained sections of 48 subjects enrolled in the study have been evaluated on the basis of the WHO classification for liposarcoma and sections stained using p53 and MDM2. Statistical Analysis Used: Chi-Square test was applied. Results: 20 subjects were diagnosed with well-differentiated liposarcoma (WLS), 16 myxoid liposarcoma (ML), 7 pleomorphic liposarcoma (PL), and 5 de-differentiated liposarcoma (DLS). The number of cases stained positive with MDM2 and p53 were positive correlated in all subjects ( P = 0.02). p53 and MDM2 positivity increased in high grade tumors ( P = 0.01). Conclusion: p53 and MDM2 immuno-reactivity was found to be potentially useful in liposarcoma diagnosis but a definitive implication would be rather unhealthy due to the small number of cases in our study.

Uzun tübüler kemik yerleşimli enkondromların düşük evreli kondrosarkomlarla tanısal ayırımı zordur. Bu çalışmada uzun tübüler kemik yerleşimli kıkırdak lezyonu olup ameliyat öncesi enkondrom tanısı konulan 17 olgunun verileri retrospektif olarak değerlendirildi. Bu amaçla Uludağ Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalında 2005 ile 2012 yılları arasında uzun tübüler kemik yerleşimli enkondrom nedeniyle intralezyoner küretaj ve allogreft uygulanan 14 hasta, biyopsi tanısı enkondrom olan ancak intralezyonel küretaj sonra sı evre I kondrosarkom tanısı konulan 2 hasta ve evre II kondrosarkoma dönüşen 1 hastanın dosyaları değerlendirildi. Semptomu olmayan 4 hastada tümör tesadüfen saptandı. Tömörün lokalizasyonu 8 olguda distal femur, 6 olguda proksimal humerus ve 3 olguda proksimal tibia yerleşimliydi. İntralezyoner küretaj ve allogreft ile tedavi edilen enkondrom tanılı 14 olguda nüks veya malign transformasyon görülmedi. Sonuç olarak bu lezyonlarda doğru tanı ve tedavi, klinik, radyolojik ve patolojik verilerin birlikte değerlendirilmesi ile mümkündür. Diagnostic distinction between enchondromas located in long tubular bones and low-grade chondrosarcomas is difficult. The data of 17 patients with long tubular bone cartilage lesions whose preoperative diagnoses were enchondromas were retrospectively analyzed. The files of the patients who were admitted to the Department of Orthopedics and Traumatology of Uludag University School of Medicine between 2005 and 2012 were assessed and 14 patients who underwent intra-lesional curettage and allograft implantation for enchondromas, two patients with preoperative diagnosis of enchondroma which were realized to be stage I chondrosarcomas after intralesional curettage, and one patient with enchondroma which transformed into stage II chondrosarcoma during follow up were examined. Enchondromas were incidental ly found in four asymptomatic patients. The tumor was in the distal femur in eight cases, proximal humerus in six cases, and proximal tibia in three cases. Fourteen cases with enchondromas who were treated with intralesional curettage and allograft implantation were free from recurrence and malignant transformation during the follow up. In conclusion, correct diagnosis and treatment of enchondromas require evaluation of the clinical, radiological and pathological data in conjunction.

Ossified cephalhematoma is a rare clinical entity. Even though cephalhematoma is frequently encountered, ossified cephalhematoma occurs only sporadically. We report a 13-week-old boy who was admitted to neurosurgery clinic with deformity of the skull. A plain skull radiograph showed radiolucent areas in the right parietal region. CT scan of the head showed thickened right parietal bone and a low-density lesion between bony layers. 3D CT of the skull showed bony protrusion of the right parietal bone. A cosmetic surgical procedure was performed for the patient, and biopsy of the bony lesion confirmed ossified cephalhematoma. We discuss diagnosis, pathogenesis, and treatment of ossified cephalhematoma.

Involvement of the iliac bone and a sacroiliac joint with malignant tumours is not uncommon, treatment is difficult due to the anatomy of the pelvis. Resection of the tumour mass must be extensive in order to achieve safe margins, but this may lead to instability and poor results. We present a new technique for reconstruction after resection of the iliac bone and sacroiliac joint including a sacral ala, and we present two illustrative cases, with 2 years follow-up. Following en bloc resection of a chondrosarcoma in the iliac bone, two or three polyaxial pedicle screws were placed transversly into the sacrum. Two polyaxial pedicle screws were also inserted into the remaining pubic and ischial bone respectively. After completion of the construct with rods, a cortical strut graft from the ipsilateral fibula was placed between the rods. Next a split mesh was placed around the implants and was filled with 60 cc bone chips allografts. Both patients were mobilized with crutches and partial weight bearing for 4 weeks and then fullweight bearing. After two years follow-up, they were ambulatory without external support and their radiological results remained satisfactory. This technique for reconstruction after type I pelvic resection is advantageous in that it saves mobile lumbar segments.

Osteosarkom 20 yaş altı görülen en sık malign kemik tümörüdür. Ergenlik döneminde görülme sıklığı pik yapar. Cerrahi ve kemoterapi ile tedavi edilir. Preoperatif kemoterapi sonrası eksize edilen tümör yerine genelde bio-uyumlu metal protezler kullanılmaktadır. Bazen kemik greftleri veya hastanın kendi kemiği de, dış ortamda yüksek doz radyasyon uygulanıp, otoklavize edilip veya pastorize edilip tekrar kullanılabilmektedir. Bu yazıda sunulan olgu 24 yaşında erkek hastadır. Hastanın temel şikayetleri sağ uylukta ağrı ve kitle olup yapılan biyopsi sonrası hastaya osteosarkom tanısı konuldu. Hastaya ameliyat öncesi kemoterapi uygulandı ve daha sonra total olarak rezeke edilen femur diafizinde önce kabaca tümör dokularından mekanik olarak temizlendi daha sonra pastörisazyona tabi tutuldu ve tekrar yerine konan parça intramedüller çivi ile tespit edildi. Kaynama sağlanması için hastada proksimal ve distal osteotomi hatlarına damar pediküllü kot grefti kullanıldı. Postoperatif üçüncü yılında lokal yada sistemik nükse rastlanmadı. Pastorizasyon ile rezeke edilen kemiğin otogreft olarak kullanıldığı; amputasyona ve tümör protezine ihtiyaç duyulmadan osteosarkom tedavisinde rutin uygulamanın dışında olan olgumuzu sunuyoruz. Osteosarcoma is the most commonly occuring malign tumour in the under 20 age group and the frequency reaches a peak in adolescence. Treatment is by surgery and chemotherapy. Following preoperative chemotherapy, a biocompatible metal prosthesis is generally used in the site of the excised tumour. Sometimes bone grafts or autografts, by external high dosage radiation or autoclavisation or pasteurisation, can be recycled. This paper presents the case of a 24 year old male patient. The initial complaint was of pain in the right thigh and following the biopsy of a mass which had formed, the patient was diagnosed with osteosarcoma. The patient received preoperative chemotherapy then the femur was totally resected and the tumour tissue in the diaphysis was roughly cleaned mechanically then pasteurisation was applied and the replacement part was fixed with intramedullar nailing. To achieve union, a pedicled vascularized elevated graft was used on the proximal and distal osteotomy lines. By the third postoperative year no local or systemic recurrence had been observed. This case is presented as an exception to the routine treatment of osteosarcoma with the use of pasteurisation with resected autograft without there being any need for amputation or tumour prosthesis.

Hypercalcemia may be seen in children with malignancy. We report a 4-year old child with rhabdomyosarcoma that initially presented with signs of hypercalcemia and bone involvement.

Sinovyal Sarkom tüm yumuşak doku sarkomlarının %5-10’unu oluşturur. Sıklıkla 3.-5. dekad arası görülür. Olguların %65’i alt ekstremite yerleşimli olup diz çevresi en sık yerleşim yeridir. Bifazik tip, monofazik fibröz tip ve kötü diferansiye tip olmak üzere 3 histopatolojik tipte görülür. Histopatolojik tanısı mikroskobik bulgular, epitelyal markırlarda pozitif boyanma ve t(X;18)translokasyonunun belirlenmesi ile konur. Prognozu kötü olup 5 yıllık ve 10 yıllık sağkalım oranları %38-76 ve %20-63’tür. Uludağ Üniversitesi Tıp Fakültesi Patoloji Anabilim Dalında 2005-2009 yılları arasında sinovyal sarkom tanısı alan 20 olguya ait preparatlar ve immünboyamalar retrospektif olarak yeniden incelendi.Çalışmanın sonunda serimizin küçük ve takip süremizin az olmasına rağmen tümör çapı, tümör lokalizasyonu, yaş ve histopatolojik tip gibi prognoza yönelik kriterler dikkate alındığında bulgularımızın literatür bulguları ile uyumlu olduğu ve uzun süreli takipli daha büyük serili çalışmalarla prognoza yönelik daha sağlıklı verilere ulaşılabileceği kanısına varıldı. Synovial Sarcoma accounts for 5-10% of all soft tissue sarcomas.It is mostly seen in 3.-5. decades.Location of %65 of cases is lower extremity and most common location is around knee.There are three histopathologic types.These are biphasic, monophasic and poorly differentiated.Histopathologic diagnosis is given by microscopic finding, positive staining in epithelial markers and determining t(X;18) translocation.Prognosis is worse and 5 year and 10 year survival rates are %38-76, %20-63 respectively.In this study, preparations and immunstainings of 20 cases which were diagnosed synovial sarcoma between 2005-2009 in pathology department of Uludag University Medical Faculty are re-examined retrospectively. In conclusion, when the criterias such as the prognostic ones (age and histopathological type)and diameter of and localization of the tumor are taken into consideration, the decision was made as our findings are consistent with the literature even though follow-up and the number of our cases is low. Also, it can be said that better results regarding prognosis can be reached by recruiting larger number of cases and longer follow-up.

Bu deneysel çalışmada tavşanlarda oluşturulan deneysel osteoartrit modelinde eklem içi uygulanan insan amniyotik sıvı’nın (İAS) eklem kıkırdağı ve sinoviyal dokuya etkisinin araştırılması amaçlanmıştır. Osteoartrit geliştirilmek için 20 tavşanın sağ dizinin ön çapraz bağı kesildi. Dört hafta sonra 10 tavşana birer hafta ara ile 3 kez eklem içi 0,5 ml İAS enjeksiyonu uygulandı. (Grup 1). Diğer 10 tavşanda kontrol grubu olarak kaydedildi ve herhangi bir tedavi uygulanmadı. (Grup 2). En son uygulanan eklem içi enjeksiyondan 12 hafta sonra her iki grupdaki tavşanlar sakrifiye edildi. Eklem kıkırdak dokusunun makroskopik değerlendirilmesi için Meachim morfolojik evreleme sistemi, histopatolojik değerlendirmesi için modifiye Mankin değerlendirme sistemi kullanılmıştır. Sinoviyal doku histolojik değerlendirmesi Yoshimi’ye göre yapılmış ve sinoviyal hücre tabakası kalınlığı da ölçülmüştür. Makroskopik incelemede Grup 1’in %100’ü evre 1–2 iken Grup-2’nin %80’i evre 3–4 olarak değerlendirildi (p

Brown tumor is an important but rare complication of primary hyperparathyroidism. It is seen in approximately 1% of the cases. Common involvement areas are long bones, ribs, hand, skull, pelvic bones, and mandible. The maxillary sinus is a rare involvement site. Patellar bone involvement has not been reported. Because brown tumor and giant cell tumor have similar histopathologic findings, the differential diagnosis is important. We present a patient with ectopic parathyroid adenoma with multiple brown tumors located in uncommon areas such as the maxillary sinus and patella. A 54-year-old female patient was operated on 3 times for the suspicion of osteal giant cell tumor. After admission, the diagnosis of primary hyperparathyroidism was suggested by the clinical history. This was confirmed by biochemical, radiologic, and histopathologic determinations. Excision of an ectopic parathyroid adenoma normalized the metabolic status. The unusual brown tumor localizations were important in the differential diagnosis of lytic skeletal lesions.