Objective. The aim of this study is to categorize the risk groups of patients with oropharyngeal carcinoma (OPC) according to p16 and p53 status, smoking/alcohol consumption history, and other prognostic factors.Study Design. The immunostaining of p16 and p53 of 290 patients was retrospectively evaluated. The history of smoking/alcohol consumption of each patient was noted. p16 and p53 staining patterns were reviewed. The results were compared with demo-graphic findings and prognostic factors. Risk groups have been classified for the p16 status of patients.Results. The median follow-up was 47 months (range 6-240). Five-year disease-free survival (DFS) rates for patients with p16 (+) and (-) were 76% and 36%, and overall survival rates were 83% vs 40%, respectively (HR = 0.34 [0.21-0.57], P < .0001), HR = 0.22 [0.12-0.40] P < .0001, respectively). p16(-), p53(+), heavy smoking/alcohol consumption, performance status; advanced T and N stages in patients with p16(-), and continuing smoking/alcohol consumption after treatment were found to be unfavorable risk factors. Five-year overall survival rates were 95%, 78%, and 36% for low, intermediate, and high-risk groups, respectively.Conclusions. The results of our study have shown that p16 negativity in patients with oropharyngeal cancer was found to be an important prognostic factor, especially for those with lower p53 expression and not smoking/consuming alcohol. (Oral Surg Oral Med Oral Pathol Oral Radiol 2023;136:80-90)

The prognostic significance of tumor volume (TV) in laryngeal squamous cell cancer (LSCC) has been demonstrated previously. Still, its clinical use is uncertain, and a method for accurate staging for TV is lacking. This study aimed to develop an objective staging and determine the effect of tumor volume on disease outcome after surgical treatment for LSCC. This study was designed retrospectively. Patients with LSCC who underwent laryngectomy were identified. Discretization for optimal scaling level of Tumor Volume (TV) was performed by Catreg Version 3.0. The rate of cancer recurrence, disease-free survival (DFS), and overall survival (OS) rate were calculated and compared between T stage and TV staging. Kaplan–Meier survival analysis was performed for comparison. 206 LSCC patients enrolled in the study. TV was found significantly higher in patients with cartilage invasion, contralateral nodal metastasis, and extranodal extension (p = 0.004, 0.010, and 0.021, respectively). TV and lymph node density LND showed a low significant positive correlation (p = 0.015, r = 0.169). TV was 7.25 + 7.53 ml on average, and TV above the mean value was found to be an independent risk factor for OS and DFS (p = 0.043, HR = 1.8; CI95

Background: Inflammatory myofibroblastic tumor is an infrequent lesion that is seen in the lungs, abdomen, skin, soft tissue, genital system, and mediastinum. It is rare in the oral cavity. Case presentation: A 58-year-old woman presented with a mass in the left buccal mucosa. An extensive surgical intervention was performed. On gross examination, the mass was 9.5 x 8 x 3.5 cm in size. Microscopically, the tumor included spindle-shaped myofibroblast-like cells intermingling chronic inflammatory cells. Differential diagnosis of inflammatory myofibroblastic tumor is extensive and includes benign and malignant spindle cell tumors, such as cranial fasciitis, solitary fibrous tumor, fibrosarcoma, and rhabdomyosarcoma. Conclusion: Inflammatory myofibroblastic tumors are classified as tumors of intermediate biological potential due to a tendency of local recurrence and low risk of distance metastasis. We found it appropriate to submit this case because of its rarity and rapid growth; also, it is the largest size oral cavity location inflammatory myofibroblastic tumor that has been reported so far.

Background/aim: Paget's disease (PD) of the breast is a very rare presentation of breast malignancy, accounting for 1%-3% of all primary breast tumors. We aimed to evaluate and compare the clinicopathological features and clinical outcome of PD accompanied by in situ carcinoma and invasive cancer. Materials and methods: We used the archive of our pathology laboratory retrospectively for age, sex, history of surgery, histopathological findings, treatment modalities, and follow-up information. We used the Kaplan-Meier method for survival analysis. Results: There were 46 female patients diagnosed with PD. In 39 (84.7%) patients, invasive carcinoma accompanied PD, while 7 (15.3%) patients had ductal carcinoma in situ. The median age at diagnosis was 53.5 years. The median follow-up period was 47 months. Of the 39 invasive carcinoma, 10 (25.6%) died during the follow-up period. Invasive ductal carcinoma group had a mean overall survival of rate of 57.8 +/- 6.6 months. According to univariate analysis, only the tumor type was found to impact overall survival (p < 0.001). Conclusions: The current study displayed the tumor type as the only parameter affecting overall survival in the invasive carcinoma group. Although it was not statistically significant, breast cancers accompanied by PD were found to be predominantly advanced stage tumors, high grade, hormone receptor negative, and HER2 positive.

Invasive cribriform carcinoma (ICC) is a rare type of a primary breast carcinoma. It is subdivided into two groups as pure and mixed types. There are limited studies comparing the pure and mixed ICC at present. We aim to investigate the clinicopathological, radiological, prognostic features, and survival outcomes of two types with reviewing the published literature. 16 pure ICC and 26 mixed ICC cases were evaluated. The population consisted of 41 female and 1 male patients. The only male patient was a pure ICC case. The median age was for pure and mixed type, 46.5 and 54 years, respectively. All ICCs were ER positive. All ICCs except one mixed ICC, were positive for PR. Only one mixed ICC was accepted HER2 positive (3+). Pure ICCs showed more favorable features than mixed ICCs such as lesser axillary lymph node involvement, lower grade, and proliferation index. Twenty-five patients had one of the following imaging methods; ultrasonography (US), mammography (MG), and magnetic resonance imaging (MRI). Irregular shape, hypoechogenicity, and spiculated margins were the most common US findings. Similarly, irregular shape+spiculated margin is the most common MG findings. The median follow-up time for pure and mixed ICC was 88 and 56.5 months, respectively. One mixed ICC case developed bone metastasis. One death occurred in each group. Reasons of death were unknown. The 5-year OS for both ICC groups was 100%. 10-year OS for pure and mixed ICCs was 100% and 90%, respectively. 5-year DFS was 100% for pure ICC, and 94% for mixed ICC.

Objective: The COL6A1 is a gene encoding the alpha 1 polypeptide subunit of collagen 6 (COL6A1), an extracellular matrix protein subunit.Programmed cell death receptor-1 (PD-1) and its ligand, programmed cell death receptor ligand-1 (PD-L1) have been shown to have a prognostic significance in clear cell renal cell carcinomas (RCCs).In this study, we evaluated the expressions of COL6A1 and PD-1 in four different RCC subtypes. Materials and methods:A total of 161 radical nephrectomy and nephron-sparing surgery cases with RCCs from five different health care centers were included in this study.Clinical data of the cases were taken from electronic records of the institutions.The pathological data were collected by an expert uropathologist and re-evaluated with slides obtained from paraffin blocks of the cases.The correlation of COL6A1 and PD-1 expression with sex, age, tumor type, lymphovascular invasion (LVI), World Health Organization/International Society of Urological Pathology (WHO/ISUP) grade, and tumor stage (pT) was analyzed with the Pearson chi-squared test.Results: Patients with sarcomatoid RCC and clear cell RCC had significantly higher COL6A1 scores and intensities than in other types of RCC (p= 0.004 and p= 0.002, respectively).WHO/ISUP grade and, COL6A1 and PD-1 staining scores also showed positive correlation (r= 0.230, p= 0.004 and r= 0.277, p= 0.001, respectively for COL6A1 and r= 0.191, p= 0.018 and r= 0.166, p= 0.041, respectively for PD-1).The staining scores and intensities of COL6A1 and PD-1 were not different between the patients with positive and negative LVI (p>0.05). Conclusion:In high-grade RCCs, we found the relationship between immunohistochemical staining scores of COL6A1 and PD-1 proteins and clinical, demographic, and histopathological parameters.Our results proved that COL6A1 and PD-1 are really promising proteins as prognostic parameters and for targeted immunotherapy.

Objective: Basal markers [cytokeratin 5/6 (CK5/6) and epidermal growth factor receptor (EGFR) are used in identifying the basal-like breast carcinoma subtype, which is associated with a poor prognosis. However, the clinicopathological significance in early-stage invasive carcinoma of no special type (IC, NST) has not been well established. Material and Method: In a five-year period, 133 female patients with early-stage IC, NST with a median follow-up time of 89 months were included. The immunohistochemistry-based molecular subtypes were identified according to ASCO/CAP guidelines in 2013. The cutoff values for basal positivity were determined as 10% for each marker. Results: Basal positivity was recorded in 83.3% (5/6) of triple-negative breast cancers, 50% (2/4) of HER2-enriched, 18.6% (13/70) of luminal B, and 8.3% of luminal A (4/48) subtype. CK5/6 and EGFR positivity were significantly associated with ER negativity (p < 0.001). EGFR positive cases were significantly associated with PR negativity and HER2 positivity compared to negative cases. However, basal positivity was not associated with the patient outcome (p = 0.006 and p- 0.004, respectively). Conclusion: Basal positive IC, NSTs were associated with hormone receptor negativity and HER2 overexpression; these patients would therefore be less likely to respond to hormonotherapy and more likely to benefit from anti-HER2 treatment as well as dual-kinase inhibitors. The lack of standardization of the definition of basal marker positivity may contribute to the conflicting results of prognostic studies. Hence, further studies focusing on developing a standard protocol for determining basal marker positivity are needed not only for IC, NST but also for other histological types of breast cancer.

OBJECTIVE:Adenoid cystic carcinoma (ACC) of the breast is an uncommon salivary type of breast carcinoma. It is a triple negative breast carcinoma with a basal-like phenotype that behaves in an indolent manner. Herein, we aimed to document clinicopathologic findings and hormone receptor status of ACC in the breast diagnosed in our institution during an eleven-year period.MATERIALS AND METHODS:Medical data of cases diagnosed as adenoid cystic carcinoma in the breast between January 2006 and December 2016 were retrospectively reviewed from hospital data base. Paraffin blocks of seven cases were retrieved from the archive of Pathology Department and androgen receptor (AR) immunohistochemistry was applied to each case.RESULTS:All of the cases diagnosed as ACC were females with a mean age 56.2. Solid growth pattern was present in two cases. P63 was constantly expressed in the whole group, and at least one additional myoepithelial marker (calponin, caldesmon, etc.) was co-expressed in tumors. While weak estrogen receptor expression was detected only in one patient, AR was strikingly expressed in majority (%85.7) of the tumors.CONCLUSION:To our knowledge, our series is the first to report such high levels of AR expression. This new finding, in turn, suggests considering hormonal therapy as an option in the management of ACC of the breast.

BACKGROUND AND AIM:In medical practice the classification of breast cancer is most commonly based on the molecular subtypes, in order to predict the disease prognosis, avoid over-treatment, and provide individualized cancer management. Tumor size is a major determiner of treatment planning, acting on the decision-making process, whether to perform breast surgery or administer neoadjuvant chemotherapy. Imaging methods play a key role in determining the tumor size in breast cancers at the time of the diagnosis.We aimed to compare the radiologically determined tumor sizes with the corresponding pathologically determined tumor sizes of breast cancer at the time of the diagnosis, in correlation with the molecular subtypes. METHODS:Ninety-one patients with primary invasive breast cancer were evaluated. The main molecular subtypes were luminal A, luminal B, HER-2 positive, and triple-negative. The Bland-Altman plot was used for presenting the limits of agreement between the radiologically and the pathologically determined tumor sizes by the molecular subtypes. RESULTS:A significantly proportional underestimation was found for the luminal A subtype, especially for large tumors. The p-values for the magnetic resonance imaging, mammography, and ultrasonography were 0.020, 0.030, and <0.001, respectively. No statistically significant differences were observed among the radiologic modalities in determining the tumor size in the remaining molecular subtypes (p>0.05). CONCLUSION:The radiologically determined tumor size was significantly smaller than the pathologically determined tumor size in the luminal A subtype of breast cancers when measured with all three imaging modalities. The differences were more prominent with ultrasonography and mammography. The underestimation rate increases as the tumor gets larger.

Parathyromatosis is a rare entity and usually appears as a consequence of the seeding on previous parathyroid surgery which was applied for the secondary hyperparathyroidism. A 63-year-old woman presented with a history of subtotal thyroidectomy 20 years ago and parathyroidectomy due to primary hyperparathyroidism (PHPT) four years ago. Imaging methods revealed multiple parathyromatosis foci on subcutaneous tissue of the neck. En-bloc resection was performed and pathological examination confirmed the diagnosis of parathyromatosis. After an uneventful 10 months, biochemical and radiological tests revealed recurrence on bilateral thyroid lodges. En-bloc resection was performed. The patient has remained well for 24 months after the second operation and has been followed-up with normal parathormone and serum calcium values. To the best of our knowledge, this report describes the twenty-first case of parathyromatosis in PHPT setting in the literature. It should be kept in mind that parathyromatosis may recur at different sites in the neck even in patients with PHPT.

Amaç: Testiküler regresyon sendromu ya da "kaybolan testis" fetal hayatta geliştiği varsayılan sonrasında atrofiye uğrayarak yok olan testis durumudur.Testis eklerinin varlığının devam etmesi, fetal hayatın başında testis olduğunun kanıtı olarak görülmektedir.Testiküler regresyon sendromu kriptorşidizm olgularının %3-5'inde görülür ve literatürdeki olguların hemen hemen tamamı neonatal dönemdedir

INTRODUCTION: The World Health Organisation defines microinvasive breast carcinoma (MIBC) as a lesion characterized by a single or multiple microscopic foci infiltrating the breast stroma, equal to 1 mm in size or smaller. The present study aims to investigate the impact of clinical and pathological parameters on the recurrence, metastasis, and prognosis in patients with the MIBC. METHODS: A group of patients diagnosed with breast cancer from January2006 to December2014 were examined retrospectively. Patients diagnosed with the MIBC were included in the study. A histopathological examination included the type of the invasive breast carcinoma, nuclear grade, number of microinvasive foci, presence of a lymph node metastasis, and hormone receptor status, diameter and grade and hormone receptor status of insitu component. In addition, local recurrence, distant metastasis, and survival characteristics and their relationship to the histopathological parameters were evaluated RESULTS: Twenty-seven patients with the MIBC were included in the study. All the patients were female. Median age was 56(25-78). Median follow-up duration was 51(15-130)months. Among 27cases of MIBC, clinical follow-up information was availiable in 25cases. There were only one invasive focus in 13 (48.1%) and multiple invasive focus in 14 (51.9%) patients. Five year disease free survival was 86.7% and 5year overall survival was91.4%. The number of microinvasive foci and ductal carcinoma in situ diamater and nuclear grade and hormone receptore expression were not related to recurrence and survival. DISCUSSION AND CONCLUSION: The number of microinvasive foci and ductal carcinoma in situ diamater and nuclear grade and hormone receptore expression were not related to recurrence and survival.

Objective: Ki67 is a nuclear protein that is expressed in all phases of the cell cycle except for G0. It is used as a marker to detect the proliferating cells. It has been shown that Ki-67 labeling index is associated with poor clinical outcome in patients with breast cancer. In this study, we aimed to evaluate the prognostic significance of Ki-67 labeling index in patients with estrogen receptor and progesterone receptor positive, HER-2 negative and axillary lymph node negative breast cancer. Methods: Patients diagnosed with breast cancer during 2006-2014, and who were followed up in the medical oncology clinic were included in the study. Immunohistochemically, nuclear Ki-67 proliferation index was evaluated. The relationship with other clinicopathologic prognostic factors was evaluated. Results: 162 patients were included in the study. In a median 85 (9-132)-months followup, local recurrence was detected in 2(1.2%) patients and distant metastasis was detected in 7(4.3%) patients. Eight (4.9%) patients died. Patients were divided into two groups using 20% cut-off value for Ki-67 labelling index, obtained by Roc curve analysis. The 7-year overall survival was 97.1% in the group with Ki-67 labeling index below 20%, while it was 90.9% in the group above the 20% value (p=0.042). Ki-67 labeling index showed positive correlation with tumor histological grade, and pathologic tumor size, and negative correlation with hormone receptors. Conclusion: Proliferation is an important indicator for predicting prognosis and treatment response in breast cancer. Ki-67 labeling index is used to determine prognosis along with other clinicopathological prognostic factors, although there is no standard cutoff value and no standard of assessment and no standard in scoring methodology.