Browsing by Author "Kotan, Ç."

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Analysis of Incidental Thyroid Cancers in Surgically Treated Toxic Goiter Patients
(Yuzuncu Yil Universitesi Tip Fakultesi, 2025) Aras, A.; Karayil, A.R.; Yilmaz, Ö.; Aras, I.; Toktaş, O.; Kotan, Ç.
Differentiated Thyroid Cancer (DTC) is the most common endocrine cancer and the frequency of DTC detection in histopathological examinations in thyroid surgeries performed for non-cancer indications is increasing. The aim of this study is to investigate the rate of incidentally detected thyroid cancer in patients who underwent surgery for toxic goiter in our clinic. Histopathological data of patients who underwent surgery with a diagnosis of toxic goiter were retrospectively reviewed. Patients were divided into 3 groups as toxic adenoma (TA), toxic multinodular goiter (MNG) and Basedow-Graves disease. The presence of malignancy and clinicopathological features were investigated RESULTS: 84% of the cases were female and 16% were male, and the mean age was 43. 202 (65%) of the toxic goiter cases had TMG, 8 (3%) had TA, and 101 (32%) had Graves' disease. Histopathologically, the malignant/benign ratio was 65 (21%)/ 246 (79%). Malignancy was detected in 3 of the 15 patients with a family history of thyroid cancer Incidental thyroid cancer was detected in 65 (21%) of the patients with toxic goiter. Thyroid carcinoma was present in 45 (22%) of the patients with toxic MNG, 1 (12.5%) of the patients with TA and 19 (19%) of the patients with Graves. Histopathological examination revealed 62 papillary (38 microcarcinoma), 2 Non-invasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features (NIFTP) and 1 medullary microcarcinoma. The incidence of incidental thyroid cancer in the patients with toxic goiter treated with surgery was found to be consistent with the literature. © 2025, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Are Appendix Weight and Length Related To Inflammatory Parameters and Alvarado Score in Acute Appendicitis
(Yuzuncu Yil Universitesi Tip Fakultesi, 2021) Kiziltan, R.; Çalli, I.; Karayil, A.R.; Aras, A.; Kotan, Ç.
We aimed to investigate if appendix weight and length affects clinical presentation. This study prospectively enrolled 50 patients who were operated with the diagnosis of acute appendicitis. The appendix material was weighed in milligram. Then, the diameter of the appendix was measured in millimeter from its widest point using a surgical ruler. The length of the appendix was measured in millimeter using the same ruler. As appendix length may have influenced its weight, weight in milligram per millimeter was used for standardization. The obtained value was expressed as the unit weight (mg/mm). In order to make a comparison by the obtained unit weight, the patients were divided into two groups. Among 50 patients enrolled in the present study, 24 (48%) were men and 26 (52%) were women. The mean CRP level of the study population was 29.4 (3-160). The mean appendix diameter measured with ultrasonography at the preoperative period was 8.49 mm (range 6-13 mm), and the mean appendix diameter measured with a ruler at the postoperative period was 10.3 mm (range 8-20 mm). There was approximately a 2 mm difference between these measurements which were made from the widest points. In conclusion, it was found that the unit weight of the appendix increased proportionally to the CRP level. The appendix would be more edematous, have a greater diameter and weight, and be more likely to perforate in patients with a higher unit weight. © 2021, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Breast Hamartoma: Radiologic Appearances
(2003) Harman, M.; Ünal, Ö.; Uǧraş, S.; Etlik, Ö.; Kotan, Ç.
Comparison of Serum Cytokeratin-18, Cea and Ca 19-9 Levels in Esophageal and Gastric Cancers
(2004) Tuncer, I.; Dülger, H.; Uygan, I.; Öztürk, M.; Kotan, Ç.; Şekeroǧlu, R.
The aim of this study was to determine clinical value of alone and combined use of serum cytokeratin (CK)-18, carcinoembryonic antigen (CEA) and CA 19-9 in esophageal squamous cell carcinoma and gastric adenocarcinoma. Serum tumor markers were measured in 60 patients who had esophageal squamous cell carcinoma or gastric adenocarcinoma. Thirty healthy subjects served as controls. In patients with gastric adecarcinoma serum CK-18 levels were significantly increased compared to both esophageal squamus cell carcinoma and control groups (p<0.01, p<0,05 respectively). But there was no significant difference in CK-18 levels between esophageal squamous cell carcinoma patients and healthy subjects (p>0.05). On the other hand, serum CEA and CA 19-9 levels did not differ between groups (p>0.05). The sensitivity of serum CK-18, CEA and CA19- 9 in esophageal squamous cell carcinoma were 53%, 70% and 66%, respectively. For gastric adenocarcinoma, the sensitivity of each tumor marker was similar 70%, 70% and 70%, respectively. CK-18/CA19-9 combination in the esophageal (83%) and gastric carcinomas (93%) were found to be more sensitive than other tumor markers when these markers were evaluated in combination. CEA exhibited the highest sensitivity for esophageal squamous cell carcinoma compared to CK-18, and CA19-9. However, the sensitivity of all tumor markers in gastric adenocarcinoma were similar. The combination of CK-18 and CA19-9 could increase the diagnostic sensitivity in esophageal and gastric carcinomas.
Correlatıon of the Results of Fnac and Hıstopathologıcal Examınatıons İn Thyroıd Nodules
(Yuzuncu Yil Universitesi Tip Fakultesi, 2024) Aras, A.; Karayıl, A.R.; Çallı, I.; Toktas, O.; Kiziltan, R.; Kotan, Ç.
We aimed to evaluate the effectiveness of Fine Needle Aspiration Cytology(FNAC) in thyroid nodules by comparing the thyroid FNAC results and histopathological results of patients who underwent thyroidectomy surgery in our clinic. FNAC results of 1229 patients who underwent thyroidectomy for various indications in the General Surgery Clinic at Van Yuzuncu Yil University, Faculty of Medicine Hospital between January 2014 and December 2020 were categorized according to the Bethesda reporting system and compared with histopathological results. The cases were between ages of 18-78 with the mean age of 45.22 years and the female/male ratio was 1032(%84) /197(%16). According to the FNAC results, 8% of the patients were Bethesda-3, 12% were Bethesda-4, 33% were Bethesda-5, and 47% were Bethesda-6. According to histopathological results, malignancy was detected in 9.2% of patients in Bethesda-3, 22.8% of patients in Bethesda-4, 78.8% of patients in Bethesda-5, and 97.9% of patients in Bethesda-6. Malignancy detection rates were compatible with Bethesda 4, 5 and 6, but were incompatible with the Bathesda 3 category. We found a sensitivity of 95.4%, a specificity rate of 67%, a positive predictive value of 90% and a negative predictive value of 82%, and an accuracy rate of 89%. FNAC is an effective and reliable method in the evaluation of thyroid nodule. © 2024, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Differential Diagnosis of Papillary Thyroid Carcinoma: Immunocytochemical Study of 112 Cases
(2005) Kösem, M.; Polat, S.; Öztürk, M.; Kotan, Ç.; Özbek, H.; Algün, E.
Papillary carcinoma is diagnosed mainly by its classical papillary structures and nuclear changes. However similar structural and cytological features may also be seen in other lesions of thyroid. Immunohistochemical staining methods help in these circumstances that cytological features do not suffice for differential diagnosis. In this study we stained 112 parafin-embedded blocks with thyroidal lesions (60 papillary carcinoma and 52 other benign or malignant thyroidal lesions) with HBME-1, CK-19, S-100 and EMA. Papillary carcinomas were stained 8.3% weakly, 90% moderately and strongly with HBME-1; 11.7% weakly, 88.3% moderately and strongly with CK-19; 50% weakly, 50% moderately and strongly with EMA; 26.6% weakly, 48.4% moderately and strongly with S-100. Other thyroid lesions were stained 36.5% weakly, 5.8% moderately with CK-19; 26.6% weakly, 15.4% moderately with EMA; 7.7% weakly, 1.9% moderately with S-100. None of the thyroid lesions, but papillary carcinoma, were stained with HBME-1. Papillary carcinoma cases had significantly higher staining with all four markers. However, HBME-1 and CK-19 were considered more valuable in differential diagnosis for papillary carcinomas, since they showed moderate and strong staining. Also high sensitivity and specificity of HBME-1 makes it a good marker for the diagnosis of papillary thyroid cancer.
Factors Affecting Mortality in Emergency Surgery in Cases of Complicated Colorectal Cancer
(Medical Association of Zenica-Doboj Canton, 2016) Kızıltan, R.; Yılmaz, Ö.; Aras, A.; Çelik, S.; Kotan, Ç.
Aim To evaluate retrospectively demographic, clinical and histopathological variables effective on mortality in patients who had undergone emergency surgery due to complicated colorectal cancer. Methods A total of 39 patients underwent urgent surgical interventions due to complicated colorectal cancer at the Department of General Surgery, Dursun Odabaş Medical Center, between January 2010 and January 2015. Thirty three of these were included in the study. Six patients were excluded because complete medical records had been missing. Medical records of the 33 cases were retrospectively reviewed. Results There were 14 (42.5%) male and 19 (57.5%) female patients. Mean age was 60 years (range: 32- 83 years); 14 (42.5%) patients were less than 60 years old, while 19 (57.5%) were 60 years old or older. Operations were performed due to perforation (39.3%) and obstruction (60.6%) in 13 and 20 patients, respectively. Tumor localization was in the right and transverse colon in nine (21.2%) and in the left colon in 24 cases (72.7%). Eleven (33.3%) patients underwent resection and anastomosis, 13 (39.3%) resection and ostomy, and nine (27.2%) patients underwent ostomy alone without any resection. Postoperative mortality occurred in nine cases (27.2%). Conclusions High mortality should be expected in females older than 60 years with a left sided colon tumor or with another synchronous tumor and in perforated tumors. Unnecessary major resections should be avoided and primary pathology should be in the focus of treatment in order to decrease the mortality and morbidity rates. © 2016, Medical Association of Zenica-Doboj Canton. All rights reserved.
Fine Needle Aspiration Biopsy and Comparison With Paraffin Section Results: a Prospective Cohort Study
(Yuzuncu Yil Universitesi Tip Fakultesi, 2022) Kiziltan, R.; Kotan, Ç.
In this study, we investigated the diagnostic value of intraoperative fine needle aspiration biopsy (FNAB) to determine thyroid cancer in patients with multinodular goiter or solitary nodules/dominant nodules and the results from intraoperative FNAB and paraffin sections were compared in order to determine whether intraoperative FNAB could be an alternative to frozen section analysis. 40 patients were included in the study. During thyroidectomy, intraoperative FNAB was performed and results were classified as malign, benign and suspicious/indeterminate. FNAB and paraffin section results were compared in all patients and evaluated in terms of FNAB sensitivity, specificity, positive/negative predictive values and overall accuracy. Among the 40 patients undergoing thyroidectomy, 7 were identified as thyroid cancer with paraffin section analysis. With intraoperative FNAB, two of the 40 patients were classified as malignant, three had suspicious lesions or ex tremely degenerated cells in which histopathologic evaluation was impossible. Diagnostic analysis of intraoperative FNAB for thyroid cancer revealed 33.33% sensitivity, 100% specificity and 94.59% overall accuracy. The positive and negative predictive values were 100% and 88.57% respectively. Thyroid nodules found to be malignant as a result of FNAB were also found to be malignant in histopathological evaluation. However this was not the case for thyroid nodules found to be benign in FNAB. That is w ith FNAB some malignant nodules may be erroneously classified as benign. Therefore although FNAB has an important role in the management of thyroid nodules it is not sufficient in the detection of malignant cases. © 2022, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Male Breast Cancer (Case Report)
(2003) Alici, S.; Kösem, M.; Çalka, Ö.; Kotan, Ç.; Mercan, R.
In this report, a 65 year-old man diagnosed as breast cancer with lung metastasis is presented. The patient was misdiagnosed as infection many times for the previous 4 years. Although breast cancer is rare in males, the importance of biopsy and histopathologic examination in nonhealed infiltrative skin lesions of male breast, is emphasized.
Measurement of Postoperative Liver Volume Changes in Patients With Gastric Cancer by Computed Tomography
(Yuzuncu Yil Universitesi Tip Fakultesi, 2023) Yokuş, A.; Arslan, H.; Akdemir, Z.; Akbudak, İ.; Almalı, N.; Kotan, Ç.; Doğan, E.
One of the most prevalent cancer worldwide is gastric cancer. Surgical treatment is the only curative method. In this study, we aimed to investigate the changes in liver volume before and after open gastrectomy in patients diagnosed with gastric cancer. We retrospectively analyzed the computed tomography scans of 70 patients who underwent gastric cancer surgery between June 2013 and December 2020. Preoperative and postoperative total liver volume, the volume of segments II-III, and segment IV were measured. The data obtained from volume measurements were compared statistically. Of the 70 subjects included in the study, 48 were male and 22 were female, with an average age of 64.2±11.8 years. In the postoperative phase, the volume of segments II-III and IV dropped significantly compared to the preoperative period (p=0.001 for both). Total liver volume exhibited a mild decrease in the postoperative period, but the total volume loss was not statistically significant (p=0.744). In this study, we detected significant volume loss in segments II-III and segment IV after open gastrectomy. However, the total liver volume reduction was less. © 2023, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
The Presence of Erythropoietin Receptor in Parathyroid Cells
(Editrice Kurtis s.r.l., 2007) Öztürk, M.; Üstek, D.; Akbaş, F.; Kösem, M.; Abaci, N.; Alagöl, F.; Kotan, Ç.
Context: Effects of erythropoietin on parathyroid cell function has not been studied before. Objective: We aimed to demonstrate whether erythropoietin receptor present in parathyroid cells. Design: The specimens of normal parathyroid gland, parathyroid adenoma and hyperplasia were retrieved from our pathology archieves. The sections were stained immunohistochemically. Quantitative gene expression study was performed for erythropoietin and erythropoietin receptor. Results: Erythropoietin receptors were detected by immunohistochemical staining and by its gene expression. Its density was higher in normal parathyroid, followed by parathyroid adenoma and hyperplasia. Conclusion: Erythropoietin receptor is present in normal parathyroid, parathyroid adenoma, and hyperplasia. © 2007, Editrice Kurtis.
A Rare Case of Secondary Hydatid Cyst: Uterus and Colon Locations in the Same Patient
(Galenos Publishing House, 2019) Beyhan, Y.E.; Yılmaz, H.; Taş Cengiz, Z.; Yıldızhan, R.; Kotan, Ç.; Batur, A.; Halidi, A.G.
The aim of the present study was to present a case with secondary hydatid cysts in both uterus and colon. The patient was a 71-year-old female living in Hakkari, Turkey. She was admitted to the Van Yuzuncu Yil University Faculty of Medicine Medical Center with complaints of chronic abdominal and pelvic pain, and swelling in the abdomen. First, the sagittal T2 weighted magnetic rezonance imaging (MR) showed a type-3 cyst hydatid with daughter vesicles located at the posterior of uterus. Later, MR revealed a type-2 cystic lesion with detached membrane adhered to the anterior wall of colon and it was reported to be associated with abdomen. When the previous liver surgery history of the patient was kept in mind, the new finding was suggestive of a secondary cystic hydatid . In conclusion, it is possible to diagnose secondary cystic echinococcosis in patients with a history of primary cyst surgery in liver or any other organ by combining the symptoms and imaging findings. ©Copyright 2019 Turkish Society for Parasitology-Available online at www.turkiyeparazitolderg.org.
Single Center Experience on Colonic Volvulus; Is Ct Necessary for Diagnosis
(Yuzuncu Yil Universitesi Tip Fakultesi, 2020) Aydın, M.; Özer, S.; Dirik, Y.; Ölmez, S.; Kotan, Ç.; Demir, C.
Colonic volvulus is rare but hazardous cause of bowel obstruction. We tried in this study to assess efficacy of plain x-ray and endoscopic decompression in diagnosis and treatment, respectively. A total of 34 patients diagnosed with colonic volvulus were retrospectively analyzed and success rates of endoscopic decompression were noted. Descriptive statistics for continuous variables were expressed as Mean±Standard Deviation and Median (Min-Max), and it is expressed as number and percentage for categorical variables. Correlations between some parameters in colonic volvulus patients were examined. A total of 34 patients, 76% (n = 26) male and 24% (n = 8) female, were included in the study. All patients except those with mucosal necrosis underwent successful colonoscopic detorsion (n=29; 85%). Plain x-ray alone was sufficient for diagnosis in 94%. Colonoscopic detorsion, by gaining time for elective surgery, is an effective treatment modality and computed tomography (CT) is not necessary for diagnosis in colonic volvulus. © 2020, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Small Cell Carcinoma of the Esophagus: Report of a Case With Review of the Literature
(2002) Alici, S.; Özen, S.; Kotan, Ç.
Primary small-cell carcinoma of the esophagus is a rare tumor that disseminates early and has a uniformly poor prognosis if untreated. We report on a patient with esophageal small-cell carcinoma treated with combination chemotherapy following surgical resection. A 48-year-old female had an ulcerated tumor in the distal part of the esophagus, which was microscopically diagnosed as esophageal small-cell carcinoma. Computed tomography (CT) of the chest and abdomen showed no lymphadenopathy or distant metastatic disease. Chemotherapy plus radiation therapy was planned but the patient refused the proposed treatment due to socieconomic reasons. Subsequently, subtotal esophagectomy with lymphadenectomy (3 periesophageal nodes) was performed in another hospital. The histopathologic diagnosis of the primary tumor was small-cell carcinoma and the resected lymph nodes also contained metastatic deposits. On the second postoperative month she was admitted with hepatic metastases. Combination chemotherapy with etoposide 120 mg/m2/day on days 1 to 3, and cisplatin 75mg/m2/day on day 1, given intravenously (i.v.) every 3 weeks was started. After 3 courses, the patient achieved complete remission. Esophageal small-cell carcinoma is an aggressive tumor. Patients with disseminated disease should receive combination chemotherapy along with symptomatic treatment.
An Unusual Choledochal Echinococcosis
(2006) Kisli, E.; Baser, M.; Kotan, Ç.; Arslantürk, H.H.; Etlik, Ö.; Bayram, I.
Hydatid disease caused by the Echinococcus granulosus is a common health problem in Turkey, Middle East and Mediterranean Countries. The most affected organs are the liver and the lungs. The other organ involvements such as spleen, kidney, brain and muscle are rare. Here we present a case of hydatid cyst of the choledochus with an inactive group of liver hydatid cyst, producing obstructive jaundice.