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We report the case of a 73-year-old man with diffuse calcification in both upper and lower limb arteries. This condition, termed Mönckeberg’s arteriosclerosis, was accompanied by three-vessel disease needing coronary artery bypass grafting. The diagnosis of arteriosclerosis was further verified by histopathology. The use of radial artery for coronary artery bypass grafting was prevented due to the heavily calcified nature of the vessel. Saphenous veins were harvested for non-left anterior descending arteries. Coexistence of Mönckeberg’s arteriosclerosis and atherosclerosis is possible and it affects the surgeon’s preference in conduit selection.

Pancreatic hydatid cyst is a rare disease found mostly in endemic regions. Having no specific clinical signs, it may present with tension related abdominal pain, dyspepsia, a palpable mass, and signs of external pressure on the surrounding organs in accordance with localization of the lesion. Pancreatic carcinoma as a neoplastic pathology with poor prognosis can have various clinical presentations changing with localization of the tumor which sometimes has cystic components. Due to the distinct nature of these pathologies, surgical approach can be fairly different. In this report, we present a case of a 70-year-old patient who had an isolated hydatid cyst in the tail of the pancreas with an incidental pancreatic carcinoma in the corpus of the pancreas. The patient was treated with a subtotal pancreatectomy, having no problems in the postoperative period leading to uncomplicated discharge.

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Lipofibromatous hamartoma (LFH) is a rare, benign, tumor-like soft-tissue lesion that affects the peripheral nerves and forms a palpable neurogenic mass. Lipofibromatous hamartoma is associated with pain and sensory and/or motor deficits in the area of innervation of the affected nerve. This report describes a rare case of LFH of the plantar nerve. A 48-year-old woman presented to our outpatient orthopedic clinic with pain and a burning sensation on her left foot. The patient had a history of Morton's neuroma and had undergone a tarsal tunnel operation 2 years earlier at another center. None of her symptoms was alleviated by two previous operations. Magnetic resonance imaging with contrast revealed tenosynovitis of the flexor hallucis longus tendon and signal changes at deep tissue planes of the foot at the levels of the second and third toes, on the dorsal site and subcutaneous soft-tissue planes, suggesting edema and Morton's neuroma. The lesion was excised under spinal anesthesia, and histopathologic examination of the specimen revealed a diagnosis of LFH. The patient was discharged without any symptoms and her foot was normal at 8-month outpatient follow-up, with no indications of postoperative complications and/or recurrence.

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Amaç: Tiroid papiller karsinomu genellikle genç erişkinlerde görülen bir tümör olup pik insidansı 3. ve 6. dekadlardadır. Yaş artışı prognozu olumsuz etkileyen en önemli faktördür. Bu çalışmada tiroidin malign tümörlerinin epidemiyolojisini, histomorfolojik özelliklerini ve 60 yaş üzeri tiroidektomili hastalarda papiller tiroid karsinomu görülme oranını belirlemeyi amaçladık.Materyal-metod: Ocak 2014-Ocak 2018 arasında merkezimizde incelenmiş tüm tiroidektomi materyalleri retrospektif olarak incelendi. Malign tanı almış olgular çalışmaya dahil edildi. Hasta yaşı, cinsiyeti, tümör çapı, tümör görülme oranı kriterleri esas alınarak epidemiyolojik veriler belirlendi. Tümörlerin histomorfolojik parametreleri incelendi ve 60 yaş üzeri hastalarda tiroid papiller karsinom görülme sıklığı saptandı. Bulgular: Toplam 135 adet tiroidektomi operasyonu geçirmiş olgunun 92’si (%68) benign, 43’ü (%32)   malign tanı almıştır. 39 olguda (%91) tanı papiller karsinom ve papiller mikrokarsinom iken 3 olgu (%7) medüller karsinom, 1 olgu (%2) folliküler karsinom tanısını almıştır. Olguların büyük bir çoğunluğunu (n=23; %59) foliküler varyant, 11 tanesini (%28) klasik varyant, 5’ini (%13) onkositik varyant papiller karsinom oluşturmaktadır. Toplam 29 adet 60 yaş ve üzerindeki hastanın 24’ü (%83) kadın, 5’i (%17) erkektir. Hastaların 22’sinde (%76) tanı benign; 7’sinde  (%24) ise tanı maligndir. Benign tanı alan hastalarda en sık görülen lezyon multinodüler guatr’dır (MNG), (n= 19, %86). Malign tanı alan 60 yaş ve üzeri hastaların tümünün tanısı papiller karsinomdur.Sonuç: Çalışmamızda, tiroidektomi operasyonu geçirmiş 60 yaş ve üzeri malign tanı alan hastalar, tüm malign tanı alan hastaların %16’sını oluşturmaktadır ve hastaların %100’ünde tanı papiller karsinom ve papiller mikrokarsinomdur. Çalışmamızın sonuçları, literatürdeki önceden yapılmış çalışmalarla uyumlu bulunmuştur.AbstractAim: Thyroid papillary carcinoma is a tumor which is generally seen in young patients. Its peak incidence is at the 3rd and 6th decades. Increase in age is the most important factor which adversely affects the prognosis. In the present study, we aimed to determine the epidemiological data and the histomorphological charactheristics of the malignant tumors of thyroid and to determine the incidence of thyroid papillary carcinoma in patients over 60 years of age. Materials and method: We retrospectively reevaluated all of the pathology reports of all of the patients who underwent thyroidectomy between January 2014 and January 2018 in our center. The cases with malignant diagnosis were included in the study. The epidemiological data were determined including the criteria of patient age, gender, greatest tumor diameter and malignancy rates. The histomorphological parameters of the tumors of the cases with papillary carcinoma were evaluated and the incidence rate of thyroid papillary carcinoma in patients over 60 years of age was determined. Results:  The pathology results of ninety two of 135 thyroidectomy  cases were benign (68%) whereas that of 43 patients (32%) were malignant. The diagnoses of 39 cases were papillary carcinoma and papillary microcarcinoma (91%) whereas 3 cases (7%) had the diagnosis of medullary carcinoma, one case (2%) had the diagnosis of follicular carcinoma. Most of the papillary thyroid carcinoma cases were follicular variant (n=23; 59%) whereas 11 cases (28%) were classical variant and 5 cases were oncocytic variant papillary carcinoma. The number of cases with the age of 60 years or older was 29. 24 of them were female (83%) and 5 of them were male (17%). The pathological diagnoses of 22 patients were benign (76%) whereas 7 patients had malignant diagnoses (24%). The most common benign lesion was multinodular goiter (n= 19, 86%). All of the malignant cases had the diagnoses of papillary carcinoma. Conclusion: In our study, patients with  age over 60 years , who had thyroidectomy with malignant diagnoses consisted 16% of the overall patients with malignant diagnoses. 100% of the patients with age over 60 years, the diagnoses were papillary carcinoma and microcarcinoma. The results of our study is in consistence with the previous studies in the literature.

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