Preoperative serum TSH is associated with PTMC, PTC and LNM. Serum TSH seems to be related with thyroid cancer regardless of autoimmunity. With the present study, for the first time, we showed an association between serum TSH and aggressive variants of PTC.

Background We aimed to compare the cytology and histopathology results of hot, cold, and warm nodules in patients who had thyroidectomy due to toxic multinodular goiter (TMNG). Methods Five hundred and nine thyroid nodules from 413 patients who had operation with TMNG were included in this retrospective study. The nodules were categorized as hot, cold, and warm groups. The cytology and histopathology results were compared. Results The 509 thyroid nodules were grouped as hot (n = 364 [71.5%]), cold (n = 122 [24.0%]), and warm (n = 23 [4.5%]) according to scintigraphy. Cytological evaluations of 364 hot nodules were as follows: 80 (22%) nondiagnostic (ND), 259 (71.2%) benign, 17 (3.6%) atypia of undetermined significance/follicular lesion of undetermined significance (AUS/ FLUS), 2 (0.5%) follicular neoplasm/suspicious for follicular neoplasm (FN/SFN), 2 (0.5%) suspicious for malignancy (SM), and 4 (1.1%) malignant. The cytology of 122 cold nodules were ND in 25 (20.5%), benign in 86 (70.5%), AUS/FLUS in 8 (6.6%), FN/SFN in 1 (0.8%), and finally SM in 2 (1.6%). The 23 warm nodules were determined as ND, benign, and FN/SFN in 7 (30.4%), 15 (65.2%) and 1 (4.3%), respectively. There were no differences according to cytological results between groups (P = .616). However, malignancy rate was 3.8% in hot nodules, it was found as 6.6% in cold nodules. The malignancy was detected in 4.3% of warm nodules. There were no differences in malignancy rates between groups (P = .459). Conclusion We demonstrated similar malignancy rates in hot nodules when compared with cold and warm nodules.

Lipomas are benign soft tissue tumors. They are the most common soft tissue tumors of adult age. They are commonly solitary, mobile, painless, and slow-growing lesions. They are usually located on the extremities but rarely can be intraabdominal. Total surgical excision is usually curative if the lesion is symptomatic. The differential diagnosis of lipomas and other soft tissue tumors is very important to prevent possible complications and metastasis. CT and MRI are often used for this purpose, but pathological examination must be done for exact diagnosis. CASE REPORT A 49-year-old patient with abdominal pain and a palpable mass lesion was admitted to the clinic. Physical examination revealed a 20-cm-diameter giant, mobile, and firm mass lesion. CT examination showed a centrally located mesenteric, encapsulated, fat-density mass lesion that absorbed the contrast agent. Its size was about 190 × 95 mm 2 , and differential diagnosis included lipoma and liposarcoma. Several lymph nodes were located peripheral to this lesion, the biggest one of them sized about 7.5 mm (Figure 1). A decision regarding surgical exploration was made, and in the operation, a 15-cm lesion was located 120 cm distal to the ligament of Trietz. The lesion was firm, mobile, and smooth surfaced. It involved the mesentery, but it was not derived from the intestine (Figure 2). Total excision with segmental resection was performed, followed by primary anastomosis after 30 cm of the resection (Figure 3). The patient discharged gas and stool on the third postoperative day. He was discharged from the hospital on the fourth postoperative day. Pathological diagnosis included mesenteric lipoma and reactive lymph nodes. No complications and complaints were reported at 1-month follow-up.

Although a relationship between direct inguinal hernia and collagen structure has been shown by some investigators, we were unable to point to any significant findings which would indicate such a relationship in indirect inguinal hernia cases. Further studies on hydroxyproline levels in peritoneal samples will be necessary to understand the role of peritoneal hydroxyproline levels in hernia formation.

Introduction: This study is an examination of the safety and efficiency of the direct trocar entry method used to create pneumoperitoneum in laparoscopic surgery.