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    Clinical Outcomes after En Bloc Resection of Periosteal Chondroma: A Retrospective Clinical Study
    (2021) Okay, Erhan; Baysal, Begümhan; Gümüştaş, Seyit Ali; Zenginkinet, Tülay; Toksöz, Ayse; Özkan, Korhan
    Aim: Periosteal chondroma is a rare chondroma that is difficult to differentiate. Its localization is similar to other surface periosteal lesions. These lesions have a wide distribution of age. Curettage, marginal excision, or en bloc resection are applied in the surgical treatment. En bloc resection is preferred to reduce recurrence. In this study, we aimed to share the experience of two orthopedic oncology centers in the differential diagnosis and treatment of periosteal chondroma. Material and Methods: Data from two clinics were analyzed retrospectively. Data were collected on demographic data (age, gender), clinical findings (pain, swelling, pressure-related symptom, duration of follow-up), radiological findings (size, bony invasion), pathology results (biopsy, excision), and postoperative complications (recurrence). Results: Fourteen patients were included in the study. En bloc resection was performed in all cases. The mean age of the patients was 31.5±16.5 (range, 8-58) years. 10 (71.4%) patients were male. The mean duration of symptoms was 6.6±4.8 (range, 0-18) months, and the mean follow-up was 46.7±39.6 (range, 6-132) months. Nine (64.3%) patients had pain. Six (42.9%) patientshadswelling.Onepatient(7.1%)hadapalpablemass.Therewasnocomplaint in 1 (7.1%) patient. One (7.1%) patient underwent biopsy. During the follow-up, no recurrence or complication was observed after en bloc resection. Conclusion: Imaging and histopathological findings of benign and malignant periosteal chondroid tumors may overlap, and accurate differential diagnosis is crucial in the treatment of these lesions. En bloc resection prevents recurrence during follow-up.
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    Clinical Results after Surgical Treatment of Spindle Cell Lipomas
    (2021) Zenginkinet, Tülay; Toksöz, Ayse; Çelik, Aykut; Okay, Erhan; Öztürk, Muhammed Beşir
    Aim: Spindle cell lipoma is a rare tumor. Although located subcutaneously, they are localized in the posterior neck, shoulder, and lumbar regions. It can radiologically mimic liposarcoma. It is important to differentiate spindle cell lipoma from atypical lipomatous tumors. In this study, we aimed to present our studies on our patients with spindle cell lipoma with histopathological and clinical findings and give brief information about the differential diagnosis of this rare lipomatous lesion. Material and Methods: A total of 29 patients (27 male, 2 female) who underwent surgical treatment for spindle cell lipoma between January 2015 and December 2020 were included in this retrospective study. All patients were presented with mass lesions, and preoperative biopsy was performed in cases with low-fat content mass lesions. Results: The mean age of the patients was 57.0±14.6 (range, 25-79) years and the mean follow-up period was 25.0±8.6 (range, 6-47) months. No additional disease was detected in the patients. Marginal resection was preferred in 5 (17.2%) patients with lesions close to neurovascular structures. Wide resection was performed in the other 24 (82.8%) patients. CD34 was positive in all lesions. In one patient, CDK4 was positive, and the diagnosis was made as atypical spindle cell lipoma. At the last follow-up, there was no complication and recurrence in any of the cases. Conclusion: Spindle cell lipomas should be regarded in the differential diagnosis of lipomatous tumors. Local excision with negative margins may prevent a recurrence. Correct histopathologic differentiation from liposarcoma is of paramount importance for appropriate treatment.
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    Clinical Results of Surgical Treatment of Giant Lipomas: A Single-Center Experience
    (2022) Okay, Erhan; Zenginkinet, Tülay; Akkaya, Arda; Özkan, Korhan; Toksöz, Ayse
    Aim: Lipomas are benign tumors, and generally present as small lesions. However, giant lipomas are less frequent. There are only a few studies regarding the surgical treatment of giant lipomas. Marginal or wide resection is usually performed; however, there is no standard surgical approach. The aim of this study was to evaluate clinical results after surgical treatment of giant lipomas and to present a differential diagnosis of lipomatous lesions. Material and Methods: A total of 42 cases (24 female, 18 male) admitted to our clinic between 2015 and 2020 due to giant lipoma with at least 10 cm dimensions were included in this study. A preoperative biopsy was performed for all cases. All patients were undergone wide excision followed by postoperative histopathological examination. Results: The mean age was 57.5±12.9 years. The median follow-up was 35 months. Anatomic localization was thigh in 16 (38.1%) patients, shoulder in 7 (16.7%) patients, hip in 5 (11.9%) patients, back in 4 (9.5%) patients, arm in 9 (21.4%) patients, and the iliac region in 1 (2.4%) patient. Wide resection was performed, and final pathology was consistent with lipoma in all cases. There was no complication except in one patient who had transient neuropraxia after removing a giant lipoma at the proximal femur. At the latest follow-up, all cases were asymptomatic with no recurrence. Conclusion: Preoperative biopsy and wide resection should be preferred for the diagnosis and treatment of giant lipomas. Wide resection may prevent a recurrence. Routine follow-up is necessary to detect possible malign transformation.