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    Imaging Characteristics of Male Breast Disease
    (Wiley-Blackwell, 2010) Adibelli, Zehra Hilal; Oztekin, Ozgur; Gunhan-Bilgen, Isil; Postaci, Hakan; Uslu, Adam; Ilhan, Enver
    The purpose of the study was to describe the imaging findings of male breast disease. One hundred and sixty-four male patients, who underwent mammography and ultrasonography (US) between January 1999 and December 2008, were retrospectively evaluated. Seventy-five patients (46%) underwent biopsy, and 89 patients (54%) were diagnosed radiologically. The radiologic and pathologic diagnoses in 164 cases of this series were 13 cancers (8%), including one ipsilateral and one contralateral breast cancers, 147 cases of gynecomastia (90%), one fibroadenoma (0.6%), two cases of fibrocystic disease of the breast (1.2%), and one epidermoid inclusion cyst (0.6%). Three mammographic patterns were adequate to describe all 147 cases of gynecomastia in our series: 53 patients (36%) had nodular gynecomastia, 46 patients (31%) had dendritic gynecomastia, and 48 patients (33%) had diffuse gynecomastia. Gynecomastia was unilateral in 65% of cases (n = 95), and bilateral in 35% of cases (n = 52). On physical examination, two of the malignant lesions had no clinic features of malignancy (15%). On mammography, 11 of 13 malignant masses were demonstrated (85%). A mass with microcalcifications was seen on mammograms in one case (9%). The contours of the masses were irregular in nine cases (82%), well-circumscribed in two cases (18%). The location of the masses was retroareolar in seven cases (64%) and eccentric to the nipple in four cases (36%). The size of the masses varied between 0.5 cm and 5 cm (mean 2.4 cm). Nipple retraction was evident in five cases (45%), and skin thickening in four cases (36%). All of the malignant masses were demonstrated on ultrasound; however, one of them was seen retrospectively after mammography. All of the masses were hypoechoic and solid, the contours were well-defined and smooth in two masses (15%), and irregular in 11 masses (85%), and five masses (39%) had posterior prominent shadowing. Axillary lymphadenopathia was detected in two cases (15%). One patient had a previous contralateral breast cancer, and one had an ipsilateral. On mammography, breast cancer characteristically exhibits an irregular subareolar mass, nipple retraction, and skin ulceration or thickening, but sometimes breast cancer has a well-circumscribed contour and punctuated microcalcifications. Ultrasonography is essential and useful for further characterization and helpful for demonstrating lymphadenopathies of the axillary region.
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    The Oncologic Safety of Sentinel Lymph Node Biopsy in Patients with Node-Positive Breast Cancer with Complete Response to Neoadjuvant Chemotherapy: A Single-Center Experience
    (Wiley-Hindawi, 2023) Tercan, Ismail Can; Zengel, Baha; Ozdemir, Ozlem; Cavdar, Demet; Tasli, Funda; Adibelli, Zehra Hilal; Karatas, Murat
    Objective. To evaluate the efficiency and safety of sentinel lymph node biopsy (SLNB) in patients with breast cancer with complete response to neoadjuvant chemotherapy (NAC). Methods. Ninety-two consecutive (T1-4 and N1-2) patients with breast cancer who had pathologic and/or clinical and radiologic axillary lymph node involvement were included. All patients received NAC. Patients with a clinical and radiologic complete response in the axilla after NAC underwent SLNB. Pathologic complete response (ypCR) was defined as the absence of residual invasive and in situ cancer, and near-complete response (ypNCR) represented in situ and/or <= 1 mm residual tumor in the breast and/or presence of malignant cell clusters (& LE;0.2 mm) and/or micrometastases (<= 2.0 mm) in the axillary lymph nodes (ALN) (ypTis/T1mi, ypN0i+/pN1mi). Results. The mean age of the 92 patients was 49.6 +/- 10.3 years and the mean follow-up was 34.0 +/- 17.8 months. With respect to breast tumors, 23 (25.0%) patients had complete and 14 (15.2%) had a near-complete response to NAC. Complete response in ALN was obtained in 39 (42.4%) patients and near-complete in six (6.5%) patients. The overall survival of the 33 patients who achieved ypCR and ypNCR was 100% and the remaining 59 patients with partial or no response to NAC was 83.1% at a mean follow-up of 34 months (p=0.063). Conclusions. In this study, no event developed in cases with ypCR and ypNCR in the breast and axilla. The persistence of the same results in long-termfollow-ups may enable the use of ypNCR as a positive prognostic marker in addition to ypCR.
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    Pineal gland metastasis of auricular squamous cell carcinoma: an unusual case and literature review
    (Assoc Radiology & Oncology, 2009) Oztekin, Ozgur; Savas, Recep; Ozan, Ebru; Apaydin, Melda; Yasar, Oeykuem; Adibelli, Zehra Hilal
    Background. The pineal gland is an unusual site for metastasis, and most metastatic pineal lesions are asymptomatic. Metastases to the pineal gland from skin cancer are extremely rare and reported mostly on autopsy series. Squamous cell carcinoma is the second most common type of skin cancer that occurs on the external ear. Auricular squamous cell carcinoma is an invasive and destructive tumour, and may cause hearing problems by local extension to the auditory canal. The vast majority of squamous cell carcinomas of the auricular region metastasize to the lung, bone, and brain. Case report. We report the case of a patient with a giant squamous cell carcinoma of the auricula with extension deep into the temporal bone, metastasizing to the lung and pineal gland. Conclusions. A metastasis should be considered as a possible cause, when encountering a mass in the pineal region, especially in elderly patients with a known primary cancer.
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    Pineal gland metastasis of auricular squamous cell carcinoma: an unusual case and literature review
    (Assoc Radiology & Oncology, 2009) Oztekin, Ozgur; Savas, Recep; Ozan, Ebru; Apaydin, Melda; Yasar, Oeykuem; Adibelli, Zehra Hilal
    Background. The pineal gland is an unusual site for metastasis, and most metastatic pineal lesions are asymptomatic. Metastases to the pineal gland from skin cancer are extremely rare and reported mostly on autopsy series. Squamous cell carcinoma is the second most common type of skin cancer that occurs on the external ear. Auricular squamous cell carcinoma is an invasive and destructive tumour, and may cause hearing problems by local extension to the auditory canal. The vast majority of squamous cell carcinomas of the auricular region metastasize to the lung, bone, and brain. Case report. We report the case of a patient with a giant squamous cell carcinoma of the auricula with extension deep into the temporal bone, metastasizing to the lung and pineal gland. Conclusions. A metastasis should be considered as a possible cause, when encountering a mass in the pineal region, especially in elderly patients with a known primary cancer.
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    Reliability of diffusion weighted MR imaging in differentiating degenerative and infectious end plate changes
    (Assoc Radiology & Oncology, 2010) Oztekin, Ozgur; Calli, Cem; Kitis, Omer; Adibelli, Zehra Hilal; Eren, Cemal Suat; Apaydin, Melda; Zileli, Mehmet; Yurtseven, Taskin
    Background. The aim of the study was to investigate the value of diffusion weighted MR imaging in the diagnosis of Modic type 1 change, which may be confused with the acute infectious spondylodiscitis on conventional MR imaging. Patients and methods. Twenty-seven patients with erosive intervertebral osteochondrosis, Modic type 1 and 18 patients with spondylodiscitis were included in this retrospective study. All images were acquired using on 1.5 Tesla MR units. Lumbar spinal MR imaging of 45 patients were retrieved from a digital database of a radiology record system and evaluated by one experienced radiologist. Patients with Modic type 1 change had CT slices obtained from the diseased disc space and the affected vertebrae. Results. Bone marrow adjacent to the vertebral end plate in both Modic type 1 change and acute spondylodiscitis were hypointense on T1-weighted images. On T2-weighted images corresponding levels of vertebral end-plates showed hyperintense signal intensity in both group. All the patients with spondylodiscitis and Modic type 1 change were hyperintense and hypointense on diffusion-weighted MR images, respectively. Conclusions. Our findings suggest that diffusion weighted MR imaging is an useful method in differentiating Modic type 1 changes from acute spondylodiscitis, both of which may mimic each other, either on clinical or conventional MRI findings.
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    A stereological study on the correlation of inferior turbinate hypertrophy and paranasal sinus disease
    (Springer, 2014) Ural, Ahmet; Songu, Murat; Adibelli, Zehra Hilal; Candan, Huseyin
    The objective of this study is to investigate the correlation between inferior turbinate size and paranasal sinus opacification on computerized tomography (CT) scans. Paranasal sinus CT scans of a total of 185 patients (92 males, 93 females) were examined in terms of sinus opacification. Sizes of the inferior turbinates were measured using stereological method and these sizes in normal and opacified paranasal sinuses are compared using one-way analysis of variance. Scans of 185 patients (93 female, 92 male) aged between 12 and 84 (mean 37.85 +/- A 16.27) years were examined in this study. Sizes of the inferior turbinates were found to be increased significantly in case of opacification of ipsilateral maxillary and anterior ethmoid sinuses (p = 0.000 and p = 0.4, respectively) on both sides. On the other hand, such a relationship could not be demonstrated for sizes of inferior turbinates with opacified or non-opacified posterior ethmoid, frontal and sphenoid sinuses. In conclusion, the combination of CT and the Cavalieri principle can provide an unbiased, direct, and assumption-free estimate of the regions of interest. The presented method can be efficiently applied without any need for special software, additional equipment, or personnel than that required for routine CT in daily use. Paranasal sinus disease, especially the inflammatory diseases of maxillary and anterior ethmoid sinuses, must be carefully investigated in cases with inferior turbinate hypertrophy.