Kadioğlu, Berrin Göktuğ; Aksoy, Ayşe Nur; Akalp Özmen, Sevilay; Uluğ, Paşa; Aydin, Özkan

OBJECTIVE Hysterectomy is one of the most common operations in gynecology. This study aimed to investigate the incidence of occult gynecologic malignancies in women undergoing hysterectomy for benign indications. METHODS In this retrospective study, the medical records of patients who underwent hysterectomy for benign indications between 2009-2019 were evaluated using the hospital’s electronic system. RESULTS During the study period, 1630 cases underwent hysterectomy for benign indications. The mean age of the patients was 48.4±6.9 years. The most common indications for hysterectomy were leiomyoma (n=788, 48.3%) and abnormal uterine bleeding (n=539, 33.1%). In the final histopathological evaluation results, malignancy was identified in 12 cases (0.73%), and the mean age of these cases was 50.41±12 years. These malignancies included four leiomyosarcomas (33.33%), one endometrial sarcoma (8.33%), two endo-metrial adenocarcinomas (16.66%), four ovarian carcinomas (33.33%), and one ovarian fibrosarcoma (8.33%). Preoperative endometrial sampling was performed in 1160 cases (71.16%). All of the occult malignant cases had preoperative endometrial sampling and no malignancy was observed in the endometrial pathology results. CONCLUSION Unexpected malignancy rate in women who underwent hysterectomies for benign indications was 0.73%, and 58.3% of them were related to the uterus, and 41.6% were related to ovarian tissues. Occult uterine and ovarian malignancies may be observed in hysterectomies performed for benign indications. Detailed preoperative evaluation is essential to avoid the increased risk of mortality and morbidity caused by late diagnosis of malignancy.

Yildirim, Nilgün; Aldemir, Mehmet Naci

OBJECTIVE To analyze the clinical and histopathological characteristics and treatment outcomes of patients treated and followed up for mucinous breast cancer (MBC). METHODS We retrospectively analyzed the clinical and histopathological characteristics and treatment outcomes of 22 patients who were diagnosed with and treated for MBC at our center between 2004 and 2016. RESULTS The mean age was 50 (range: 26–68) years. Ten (47.6%) patients were premenopausal. The tumor was in the right side in 11 patients (50%), and 64% of the patients had early-stage disease. There were six patients with the mixed subtype and 16 with the pure subtype. Except for the two patients with metastatic disease, all patients underwent surgery. Axillary lymph node involvement was detected in seven (36%) patients, and the proportion of patients with the pure subtype was 18%. The average duration of follow-up was 59 months, during which, four patients had recurrent disease. At 5 years, 81% of the patients were alive. The 5-year overall survival rate with pure MBC was 93%. CONCLUSION MBC is a rare condition and carries a good prognosis. Pure MBC has low axillary lymph node metastasis and a higher survival rate.

Yildirim, Nilgün; Şimşek, Melih; Aldemir, Mehmet Naci; Bilici, Mehmet; Başol Tekin, Salim

Objective Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumor of the gastrointestinal (GI) tract. The aim of this retrospective study was to explore the characteristics, prognostic factors, and treatment results of GIST cases. Methods Clinical and pathological data of 35 GIST patients at our center between 2002 and 2015 were reviewed. Results Total of 18 (51.4%) were women and 17 (48.6%) were men, with median age of 54 years. Common site of tumor was stomach (48.6%). Abdominal pain (37.1%) was common clinical symptom. Risk group distribution was 8.6% low, 31.4% intermediate, and 60% high-risk cases. Mean follow-up period of the patients was 34 months. Low-risk GIST can be treated with surgery alone. Recurrence was observed in only 1 of 10 patients who received adjuvant treatment. All 6 patients in whom metastasis was determined were in high-risk group, and 4 of them had liver metastasis. Metastasis was not detected in any of the patients who had <5 mitoses per 50 high-power field (HPF), but in 5 of 12 patients who had >10 mitoses per 50 HPF, metastasis was determined. Metastasis did not correlate with site or size of tumor, but was related to high mitotic rate (p=0.015). Median overall survival of the patients was 79 months. Conclusion Low-risk GIST can be treated with surgery alone. Imatinib therapy significantly improves survival of high-risk or advanced-stage GIST patients. Metastasis did not correlate with site or size of tumor, but correlation with high mitotic rate was observed.

Telkoparan Akillilar, Pelin; Yildiz, Gökhan

Breast cancer is the most commonly diagnosed type of cancer among females worldwide. It is also the leading cause of female cancer-related death in developing countries. Though novel biomarkers and new strategies for diagnosis, monitoring course of disease, and treatment of breast cancer have been found, these methods are invasive, costly, labor-intensive, and inadequate to fully gauge treatment response and disease recurrence. Therefore, novel biomarkers with greater sensitivity and specificity, and which are easy to perform are needed in breast cancer oncology. There is growing interest in the potential use of circulating tumor cells and circulating tumor deoxyribonucleic acid fragments in liquid biopsy as non-invasive biopsy materials for early detection of breast cancer, monitoring disease progression, and understanding reasons for treatment resistance. This review is a discussion of current status of utilization of these liquid biopsy materials in breast oncology.