often do not form glands or tubular structures, but infiltrate like small nests and strands of tumor cells, which are usually of the signet ring type. This morphology may mimic other primary tumors, i.e., gastric carcinoma. The lack of dysplasia or atypia in adjacent colonic epithelium suggests a metastatic growth. Immunohistochemistry may also be useful in reaching the correct diagnosis. The GCDFP-15 and ER and PgR receptors are usually positive in MBC. Unlike the original tumor, this was also confirmed in our case.Although GI tract metastases are an underdiagnosed complication of BC, we suggest that an alert physician should always suspect this possibility whenever a patient with such a medical history experiences GI symptoms.A 43-year-old female patient was referred to the breast surgery unit of our hospital. Her complain was diffuse enlargement of the right breast. She has used various antibiotics. In our physical examination, size of the right breast was twice bigger than the left one. Also, it was edematous and hyperemic with an increase in local temperature.The mammogram of the left breast was normal, but the right one had an homogenously uniform radiodense image with no evidence of normal breast tissue (B _ IRADS 5) (Fig. 1). Ultrasonography (USG) showed a lesion fulfilling the right breast tissue including low resistant arterial vasculature.A true-cut biopsy was performed. The pathologic evaluation revealed no malignancy with neutrophil predominancy. With clinical suspicion of malignancy, the patient was operated and the pathological result was a giant tubular adenoma of 14 · 13 cm (Figs. 2 and 3).To obtain accurate diagnosis and optimum surgical treatment, diagnostic suspicion and excision of clinically suspicious lesions is essential. Even if the results of radiology and true-cut biopsy reveal no
Laparoscopic cholecystectomy (LC) has the advantages of early return to full daily activity, early return to work, and better cosmetic result, as well as quickly resolving pain. Yet how this information about the procedure influences a patient's attitude toward laparocopy is not known. In this study we analyzed the factors that play role in the decision-making process of patients who choose laparoscopic surgery, and we also evaluated patients' knowledge of laparoscopy and their expectations. A questionnaire was used in evaluating 98 patients suffering from symptomatic cholelithiasis scheduled for elective laparoscopic cholecystectomy between January 2001 and January 2002. Females constituted 81% of the study population. Most of the patients (56%) were housewives. While 45% of the patients had an educational status of primary school degree only, 14% had graduated from a university. Forty-three patients described their level of knowledge about laparoscopy as "low" (had only heard about laparoscopy). In 61% of the patients the surgeon was the sole decision maker about the type of the operation. Almost none of the patients had a preference for the time of discharge from the hospital after surgery, and only three of the actively working patients offered a time interval for return to work. From this study we concluded that most patients have inadequate information about laparoscopic surgery, that the type of operation is dictated mostly by the surgeon, and that early discharge and early return to work are not important for many patients.
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