Person: ÜNVER, NURCAN
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Publication Open Access Co-existence of acute appendicitis and inflammatory myofibroblastic tumor of the small intestine: A case report(2015-09-01) Unver, NURCAN; Coban, GANİME; ONARAN, Oyku Izel; ARSLAN, ADNAN; Malya, FATMA ÜMİT; HASBAHCECI, Mustafa; ÜNVER, NURCAN; ÇOBAN, GANİME; KUNDUZ, ENVER; ARSLAN, ADNAN; MALYA, FATMA ÜMİTIntroduction: Inflammatory myofibroblastic tumor as a rare neoplastic lesion is seen most commonly in the pulmonary system. Beside the presence of limited number of inflammatory myofibroblastic tumors of the gastrointestinal tract in the literature, co-existence with acute appendicitis has not been reported before. Presentation of case: A 27-year-old woman admitted to emergency department with acute abdominal pain at the right lower quadrant. The initial diagnosis was as acute appendicitis. Intraoperatively, a mass with a diameter of almost 5 cm originated from the distal ileal segments neighboring the appendix was seen. The patient was managed by segmental resection of the small intestine including the mass with appendectomy. Histologically, there were bundles of spindle cells accompanied by lymphoplasmocytic infiltration. The immunohistochemical studies showed that tumor cells were positive for smooth muscle actin, vimentin, perinuclear activity for anaplastic lymphoma kinase and CD 68. The final pathologic diagnosis was inflammatory myofibroblastic tumor. Discussion: Concomitant resection of tumoral lesions detected in the neighbor intestinal segments during appendectomy should be considered to diagnose and treat. For the diagnosis of inflammatory myofibroblastic tumor, immunohistochemistry pattern including positivity for actin, vimentin, CD 68 and anaplastic lymphoma kinase plays a crucial role. Therefore, detailed immunohistochemistry analysis should be performed in suspicious cases. Conclusion: Coexistence of inflammatory myofibroblastic tumor located in the gastrointestinal system with acute appendicitis is a rare event. Complete surgical excision should be regarded as the mainstay of the treatment. Long-term follow up with serial imaging techniques is recommended.Publication Metadata only EUS-guided FNA of a portal vein thrombus in hepatocellular carcinoma(2015-06-01T00:00:00Z) Kayar, Yusuf; Turkdogan, Kenan Ahmet; Baysal, Birol; ÜNVER, NURCAN; Danalioglu, Ahmet; ŞENTÜRK, HAKAN; ÜNVER, NURCAN; ŞENTÜRK, HAKANPortal vein thrombosis is a relatively rare but well-known complication of cirrhosis that has a prevalence of between 1% and 5.7%. On the contrary, in case of hepatocellular carcinoma (HCC), it is a much more frequent complication. In this paper, we presented three cases that had liver cirrhosis, mass and portal vein thrombosis in liver. We were not able to diagnose the cases through imaging methods, laboratory results or histopathologically, however, they were diagnosed with endoscopic ultrasonography-fine needle aspiration EUS-FNA from portal vein thrombus.Publication Open Access A Primary Adenosquamous Carcinoma of the Stomach: Report of Two Cases(2017-07-01) Gecer, MELİN; Unver, NURCAN; HASBAHCECI, Mustafa; Gucin, ZÜHAL; Tosuner, ZEYNEP; Akcakaya, ADEM; Arici, Sema; GEÇER, MELİN; ÜNVER, NURCAN; GÜCİN, ZÜHAL; TOSUNER, ZEYNEP; ÇOBAN, EZGİ; AKÇAKAYA, ADEM; ARICI, DILEK SEMAPrimary gastric adenosquamous carcinomas are extremely rare tumors. A gradual transition between the malignant glandular and squamous components of the tumor is seen on performing a histopathological evaluation. These tumors are known to have poorer clinical outcomes than conventional adenocarcinomas. We aimed to present two cases of primary adenosquamous carcinomas that were diagnosed at the later stage in our institute.Publication Open Access The importance of upper gastrointestinal endoscopy in morbidly obese patients(2015-05-01) BAYSAL, Birol; KAYAR, Yusuf; DANALIOGLU, Ahmet; OZKAN, Tuba; KAYAR, Nuket Bayram; Unver, NURCAN; Bozkurt, SÜLEYMAN; Ince, ALİ TÜZÜN; ÜNVER, NURCAN; BOZKURT, SÜLEYMAN; İNCE, ALİ TÜZÜNBackground/Aims: Obesity is an epidemic and its prevelance and number of patients underwent bariatric surgery continue to increase worldwide. This study aimed to evaluate endoscopic findings and co-morbidities, to investigate the prevelance of Helicobacter pylori (H. pylori) infection and the relationship between body mass index (BMI) and gastroesophageal sphincter incompetency in obese patients. Materials and Methods: An upper gastrointestinal system endoscopy and mucosal sampling were performed in all patients hospitalized for bariatric surgery. Age, gender, BMI, co-morbidities and endoscopic findings were recorded. Gastroesophageal sphincter incompetency was classified according to Hill classification. The patients were divided into two groups: group I, endoscopically normal and group II, endoscopically abnormal. Results: Total 127 patients were enrolled into prospective study. Of these, 93 (%73.2) were female and the mean age was 38.9±12.5 years (range: 16-68). Abnormal endoscopic findings and H. pylori were detected in 80.4% and 44.9% of patients, respectively. In group II, patients were older, BMI higher and H. pylori more prevalent (all statistically significant). Diabetes mellitus, hypertension and dyslipidemia were the most frequent common co-morbidities. Rate of multiple co-morbidities were more common in group II. Gastroesophageal sphincter incompetency in total group was observed in a rate of 46.5% and was weakly correlated with BMI. Conclusion: Four-fifths of obese patients have at least one endoscopic abnormal finding, three fourth at least one co-morbidity and half H. pylori positivity. Upper gastrointestinal system endoscopy should be performed routinely in all patients to predict and prevent complications following bariatric surgery.Publication Open Access Use of serum and peritoneal CEA and CA19-9 in prediction of peritoneal dissemination and survival of gastric adenocarcinoma patients: are they prognostic factors?(2018-04-01) HASBAHCECI, MUSTAFA; Malya, FATMA ÜMİT; Kunduz, ENVER; Guzel, MEHMET; Unver, NURCAN; Akcakaya, ADEM; MALYA, FATMA ÜMİT; KUNDUZ, ENVER; GÜZEL, MEHMET; ÜNVER, NURCAN; AKÇAKAYA, ADEMINTRODUCTION To evaluate the impact of serum and peritoneal levels of tumour markers on peritoneal carcinomatosis and survival in gastric adenocarcinoma. MATERIALS AND METHODS Patients with gastric adenocarcinoma were evaluated with regard to serum and peritoneal carcinoembryonic antigen (CEA) and CA19-9. Numeric values and groupings based on serum and peritoneal cutoff values were used. Development of peritoneal carcinomatosis, including positive washing cytology, was regarded as main outcome. Gastric cancer outcomes as disease free and overall survival were analysed. RESULTS There were 67 patients with a mean age of 60 ± 11 years. Positive peritoneal washing cytology was significantly associated with serum CA19-9 and high serum CA 19–9 group (P = 0.033 and P = 0.011, respectively). High peritoneal CEA was shown to be significantly associated with peritoneal carcinomatosis (P = 0.032). After a median follow up of 17 months, 48 patients (71.7%) were alive. Patients with peritoneal carcinomatosis showed significant poorer prognosis as shown by overall survival rate of 28.6%. Only serum CEA was significantly associated with lower disease free and overall survival (P = 0.002 and P = 0.001, respectively). DISCUSSION AND CONCLUSION Serum CEA is shown to be significantly associated with poor prognosis for gastric cancer patients. Serum level of CA19-9 and high peritoneal CEA levels are significant predictors for positive peritoneal washing cytology and the development of peritoneal carcinomatosis, respectively. Therefore, the possible impact of serum and peritoneal tumor markers especially on the staging and prognosis of gastric cancer remains to be clarified by future studies.Publication Open Access Analysis of Appendiceal Neoplasms on 3544 Appendectomy Specimens for Acute Appendicitis: Retrospective Cohort Study of a Single Institution(2018-06-27) Destek, Sebahattin; Bektasoglu, HÜSEYİN KAZIM; Unver, NURCAN; Aydogan, CEYHUN; Timocin, GİZEM; KUNDUZ, ENVER; BEKTAŞOĞLU, HÜSEYİN KAZIM; ÜNVER, NURCAN; AYDOĞAN, CEYHUN; TİMOÇİN, GİZEM; DESTEK, SABAHATTİNBACKGROUND Appendiceal neoplasms are rare and generally determined in appendectomy specimens for acute appendicitis. Depending on a tumor's histopathology and size, appendectomy or right hemicolectomy are the surgical treatment options. Adenocarcinomas, mucinous neoplasms, goblet cell carcinoids and neuroendocrine tumors are the types of the primary appendiceal neoplasm histopathology. In this study, we aimed to determine the incidence of appendiceal neoplasms in an acute appendicitis cohort. Also, histopathological distributions, demographic data, preoperative radiological diagnosis, and intraoperative findings were revealed for analysis, retrospectively. MATERIAL AND METHODS Between October 2011 and September 2017, 3554 appendectomies were performed for acute appendicitis in Bezmialem University Hospital, Istanbul Turkey. The medical records of these consecutive 3554 patients were evaluated retrospectively. After the histopathological analysis of the appendectomy specimens, a total of 28 patients were detected as having appendiceal neoplasm including appendiceal adenocarcinoma, low grade mucinous neoplasia, and appendiceal neuroendocrine tumors. RESULTS Appendiceal neoplasms were determined in 28 out of 3554 acute appendicitis patients with an incidence of 0.78%. According to the histopathological types, 3 of the cases (10.7%) were appendiceal adenocarcinoma, 8 of the cases (28.5%) were low grade mucinous neoplasia, and 17 of the cases (60.8%) were neuroendocrine tumors. The overall incidence of the appendiceal neuroendocrine tumors was 0.48%. CONCLUSIONS The information obtained from our study suggests that pathological examination of the specimen may not be necessary if there is no doubt according to preoperative radiological diagnosis and/or intraoperative findings of the surgeon.