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Objective: Invasive lobular carcinoma (ILC) of the breast makes up 5 to 15 percent of all invasive breast cancers. It has distinctive clinical and histopathological features when compared to invasive ductal carcinoma (IDC). This study intends to describe factors influencing sentinel lymph node (SLN) positivity in patients with "pure" ILC. Materials and Methods:Data of 105 patients, who were treated at a tertiary oncology center, with lobular carcinoma of the breast that were subjected to SLN biopsy was probed retrospectively. Patients were categorized as ≤60 and >60 years of age, positive or negative for estrogen receptor and progesterone, tumor grade I, II and III, Ki67≤15% and >30%, lymphovascular invasion presence and the presence of multicentricity and multifocality.Results: Mean age at the time of diagnosis was 52 (38-81). Mean tumor size was 2.7 cm (0.7-13cm). Univariate analyses revealed a significant relationship between tumor size (≤2 cm vs >2cm) and metastasis in the SLN. This relation kept its significance in multivariate analyses. (p=0.013). Conclusion:With so many different characteristics from IDC, ILC is mostly a uniform tumor. In this study, tumor size was the only independent clinical parameter that was found related to SLN metastases.

Background: Majority of colorectal neoplasms are adenocarcinomas but there is a small percentage of tumors from other histological cell lines Method: One thousand one hundred patients who were applied surgical treatment due to colorectal cancer at general surgical clinic between years of 2010-2020 were examined. Patients have been grouped as Diffuse large b cell lymphoma (DLBCL) (group1), Malignant melanoma (group2), Medullary carcinoma (group3), Neuroendocrine tumor (group4) and they were included in the study in this way. In the groups,clinicopathological data of patients and their survival periods have been compared. Results: Twenty patients are included in our study: Group 1 was composed of 5, Group 2 was composed of 4, Group 3 was composed of 3, and Group 4 was composed of 8 patients. Emergency application rate (60%) was higher in Group 1 (p: 0.004). A verage age was above 50 in 4 groups and there was no difference between groups (p:0,966).Tumor diameter was on average (cm)(8 vs 6,55 vs 5,4 vs 3,75 p:0,073) in the groups, The number of lymph nodes dissected were (13 vs 14.5 vs 19 vs 19 p:0.373) The number of metastatic lymph nodes were ( 0 vs 1.5 vs 0 vs 0.5 p:0.188). Survival was significantly shorter in the malignant melanoma group, the longest survival was in the neuroendocrine tumor group (15.625vs8.5vs20 vs 40.857 p:0.001) Conclusions: Although clinicopathological features and postoperative follow-up results were similar, there were differences in survival among patients. Maligant melanoma histopathological type had a worse prognosis than other tumors

ÖZET GİRİŞ ve AMAÇ: Kolonoskopi, kolorektal hastalıkların tarama, tanı ve tedavisinde en önemli yöntemdir. Çalışmamızda iatrojenik kolon perforasyonunda erken müdahalenin önemine dikkat çekmek amaçlanmıştır. YÖNTEM ve GEREÇLER: 2014-2018 yılları arasında hastanemizde yapılan 9,840 kolonoskopi işlemi retrospektif olarak taranmıştır. BULGULAR: Yapılan 9,840 kolonoskopi sonrasında toplamda 5 hastada iatrojenik perforasyon olduğu görülmüştür. Dört hastada perforasyonun işlem esnasında farkedildiği ve hemen işlem sonrasında müdahale edilerek laparoskopik stapler ile onarım yapıldığı görülmüştür. Bir hastanın ise kolonoskopi sonrası birinci günde farkedildiği ve Hartman prosedürü uygulandığı görülmüştür. TARTIŞMA ve SONUÇ: Kolonoskopi güvenli bir işlem olarak tanımlansa da nadiren komplikasyonlar görülmektedir. Kolonoskopi sonrasında görülen en morbid komplikasyon perforasyondur. Literatürde perforasyon oranı %0,005 ile %0,63 arasında gösterilmektedir. Çalışmamızda literatür ile uyumlu şekilde perforasyon oranı %0,051 olarak tespit edilmiştir. Perforasyonun erken dönemde tanınması ve müdahale edilmesi hasta morbiditesi açısından çok önemlidir. Erken dönemde tanı konması durumunda endoskopik onarım, laparoskopik primer onarım gibi morbiditesi daha düşük onarımlar yapılabilmektedir. Tanının gecikmesi durumunda ise batının kontamine olması nedeniyle Hartman prosedürü gibi daha morbid müdahalelerin yapılması gerekmektedir. İatrojenik perforasyon sonrasında tedavi yöntemi seçimi; hasta özellikleri, perforasyonun lokalizasyonu, boyutu ve perforasyon sonrası geçen süreye göre vaka bazlı yapılmalıdır. Anahtar Kelimeler: Kolorektal kanser, Kolonoskopi, Perforasyon ABSTRACT INTRODUCTION: Colonoscopy is the most important method in the screening, diagnosis and treatment of colorectal diseases. In our study, it was aimed to emphasize the importance of early intervention in iatrogenic colon perforation. METHODS: 9,840 colonoscopy procedures performed in our hospital between 2014-2018 were retrospectively reviewed. RESULTS: After 9,840 colonoscopy, total iatrogenic perforation was observed in 5 patients. In four patients, perforation was noticed during the procedure and immediately after the procedure was performed and repair was performed with laparoscopic stapler. One patient was noticed on the first day after colonoscopy and Hartman procedure was performed. DISCUSSION AND CONCLUSION: Although colonoscopy is defined as a safe procedure, complications are rarely seen. The most morbid complication after colonoscopy is perforation. The perforation rate in the literature is between 0.005% and 0.63%. In our study, perforation rate was determined as 0,051% in accordance with the literature. Early recognition and intervention of perforation is very important for patient morbidity. In case of early diagnosis, endoscopic repair and laparoscopic primary repair can be performed with lower morbidity. In case of delayed diagnosis, more morbid interventions such as Hartman procedure should be performed because of the contaminated abdomen. Selec...

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