Mustafa Kemal Demir - Academia.edu (original) (raw)

Papers by Mustafa Kemal Demir

Research paper thumbnail of Magnetic Resonance Imaging of Unusual Neoplasms Related to Foramen of Luschka: A Review for Differential Diagnosis

Indian Journal of Radiology and Imaging

There are many types of neoplasms in or around the foramen of Luschka (FL), and definitive diagno... more There are many types of neoplasms in or around the foramen of Luschka (FL), and definitive diagnosis in some cases requires knowledge of imaging findings. The uncommon and challenging neoplasms with FL involvement considered in this study are exophytic brainstem glioma, primary glioblastoma of the cerebellopontine angle (CPA), primary anaplastic ependymoma of the CPA, choroid plexus papilloma of the FL, solitary FL choroid plexus metastasis, extraskeletal myxoid chondrosarcoma of the jugular foramen, paraganglioma of the jugular foramen, exostosis of the jugular foramen, psammomatous meningioma in the lateral cerebellar medullary cistern, epidermoid tumor of the fourth ventricle, and a hypoglossal schwannoma. These neoplasms may have overlapping clinical and imaging features, but some have relatively distinct imaging features. Knowledge of the key clinical and magnetic resonance imaging features of these unusual lesions with FL involvement is important for radiologists to improve di...

Research paper thumbnail of A rare case of mucosal metastases 14 years after resolution of a primary uveal melanoma

Journal of Clinical Images and Medical Case Reports, 2022

Uveal melanoma has a high metastasis rate. Following the initial diagnosis, up to 50% of patients... more Uveal melanoma has a high metastasis rate. Following the initial diagnosis, up to 50% of patients are affected by late recurrence and gastrointestinal metastasis is found to be one of the least frequent. We report the case of a 47-year-old woman who underwent proton therapy for uveal melanoma. Fourteen years after the initial diagnosis, she presented to the hospital complaining of an enduring gas in stomach. Dark colored, metastatic lesions were discovered in gastric mucosa during endoscopy and hyperintense hepatic lesions were spotted in T1 weighted MR imaging. Long term metastasis is commonly seen in patients with uveal melanoma and its management is more difficult when compared to other melanoma types, hence regular follow-ups are crucial for patient well-being. Keywords: uveal melanoma; gastric metastases; mucosal metastases; gastric mucosa; intraocular tumors.

Research paper thumbnail of Neurosarcoidosis with parenchymal nodules aligned in the temporal lobe

QJM: An International Journal of Medicine, 2021

Granulomas manifest as multiple nodules scattered in both cerebral hemispheres with nodular enhan... more Granulomas manifest as multiple nodules scattered in both cerebral hemispheres with nodular enhancement on post-contrast magnetic resonance imaging in neurosarcoidosis and mimicking metastasis. This is an interesting case report showing that cerebral parenchymal nodules may specially coalesce in a lobe, similar to pulmonary parenchymal involvement, which should be noted in neurosarcoidosis.

Research paper thumbnail of Abdominal variant of Lemierre’s Syndrome in a Patient with Pancreatic Adenocarcinoma

Medeniyet Medical Journal, 2021

Lemierre’s syndrome is an illness characterized by internal jugular vein thrombophlebitis related... more Lemierre’s syndrome is an illness characterized by internal jugular vein thrombophlebitis related to infectious agents, primarily Fusobacterium necrophorum. These bacteria, residing in both the oropharynx and the gastrointestinal tract, may lead to pylephlebitis, a serious condition that could result in the development of hepatic abscesses. This manifestation of the disease is regarded as the abdominal variant of Lemierre’s syndrome. Patients with gastrointestinal malignancies, especially those who undergo surgeries, are susceptible to the abdominal variant of Lemierre’s syndrome. Timely diagnosis is required to avoid the life-threatening complications of the abdominal variant of Lemierre’s syndrome. Diffusion-weighted magnetic resonance imaging (MRI) might be very useful in differentiating this disease from liver metastasis in patients with malignancies. Radiologists and clinicians need to be aware of this challenging condition to prevent misdiagnosis, since prompt treatment is oft...

Research paper thumbnail of Encephalomyelitis associated with Covid-19 infection: case report

British Journal of Neurosurgery, 2020

We describe a COVID-19 patient who presented with persistent headache and anosmia that was relate... more We describe a COVID-19 patient who presented with persistent headache and anosmia that was related to viral encephalomyelitis with acute lesions on MRI in both the brain and upper cervical cord.

Research paper thumbnail of Neonatal lower GIS obstruction with typical radiographic findings: Meconium Ileus

Türk Radyoloji Dergisi/Turkish Journal of Radiology, 2018

Meconium ileus is a lower gastrointestinal obstruction syndrome due to the impaction of abnormall... more Meconium ileus is a lower gastrointestinal obstruction syndrome due to the impaction of abnormally thick and sticky meconium in the terminal ileum. It is most often early manifestation of cystic fibrosis. This is a case of surgically proved meconium ileus, whose genetic profile is negative for cystic fibrosis. It is important to differentiate neonatal lower gastrointestinal obstruction and also meconium related disorders due to early treatment and better prognosis. Contrast enhanced fluoroscopic imaging is the primary and indispensable radiologic method for this purpose. We present our case with typical fluoroscopic findings of meconium ileus, along with literature review of other meconium related disorders.

Research paper thumbnail of Endometriosis in an Episiotomy Scar: Case Report

Türk Üreme Tıbbı ve Cerrahisi Dergisi, 2018

Research paper thumbnail of A Rare Cause and Complication of Acute Gastric Dilatation: Superior Mesenteric Artery Syndrome and Perforation

The Eurasian journal of medicine, 2018

Research paper thumbnail of Successful Endovascular Management of a Transplant Renal Artery Pseudoaneurysm Complicated With Arterioureteral Fistula

Progress in transplantation (Aliso Viejo, Calif.), 2017

We report a case of renal artery pseudoaneurysm at the anastomosis site complicated with arteriou... more We report a case of renal artery pseudoaneurysm at the anastomosis site complicated with arterioureteral fistula (AUF) in a 57-year-old kidney transplant recipient who presented with intermittent massive hematuria at one month post-transplant. We successfully treated the pseudoaneurysm and AUF with endovascular covered stent implantation. The diagnosis of AUF is rare and it is a condition that occurs in patients with previous pelvic or vascular surgery, chronic ureteral catheterization and radiotherapy. This diagnosis requires the expertise of the urologist, vascular surgeon and interventional radiologist. The fistula most often occur in the iliac arteries and are often associated with pseudoaneurysms or abscesses. Angiography and ureteral contrast studies (antegrade or retrograde pyelography) are the most valuable diagnostic tools. Treatment of AUF via endovascular approach using covered stents is effective and safe, and is becoming the reference treatment in AUFs.

Research paper thumbnail of Imaging Findings of the Unusual Presentations, Associations and Clinical Mimics of Acute Appendicitis

The Eurasian journal of medicine, 2017

There are many kinds of unusual presentations or associations and clinical mimics of acute append... more There are many kinds of unusual presentations or associations and clinical mimics of acute appendicitis, and definitive diagnosis requires knowledge of the imaging findings in some cases. The unusual presentations and associations of acute appendicitis included in this study are perforated appendicitis, acute appendicitis occurring in hernias, acute appendicitis with cystic endosalpingiosis, intussusception of appendix, and acute appendicitis with pregnancy. We also present uncommon gastrointestinal, urinary and gynecologic clinical mimics of acute appendicitis including anomalous congenital band, duplication cysts, giant Meckel's diverticulitis, inflammatory fibroid polyp, renal artery thrombosis, spontaneous urinary extravasation and OHVIRA syndrome. Familiarity with these entities may improve diagnostic accuracy and enable the quickest and most appropriate clinical management.

Research paper thumbnail of Coincidence of Polysplenia, Kartagener Syndrome, Dorsal Pancreas Agenesis, and Polycystic Kidney Disease in an Adult

The Eurasian journal of medicine, 2017

Here we present the case of an adult male patient with the anomalies of polysplenia, Kartagener s... more Here we present the case of an adult male patient with the anomalies of polysplenia, Kartagener syndrome, dorsal pancreas agenesis, and adult polycystic kidney disease. Familiarity with this extremely rare coincidence may improve diagnostic accuracy and patient management.

Research paper thumbnail of A Rare Cause of Acute Abdomen Due to Hemorrhage of Renal Mass: Wunderlich Syndrome

Journal of Emergency Medicine Case Reports, 2017

Renal angiomyolipomas are rare benign lesions of the kidney with an incidence between 0.1% and 0.... more Renal angiomyolipomas are rare benign lesions of the kidney with an incidence between 0.1% and 0.22% (1). They are composed of abnormal vasculature, smooth muscle, and adipose tissue. They are more likely to be symptomatic if they are larger than 4 cm, and present a history of flank pain, a palpable mass, and rarely haematuria. Also, they are most frequent etiology of Wunderlich syndrome, which is an emergency medical condition that refers to spontaneous nontraumatic bleeding confined to the perinephric space (2). Although benign, their rich neovascularization has a tendency for spontaneous rupture with consequent hemorrhage, which in some cases can be life threatening. Significant perinephric hemorrhage may occur in approximately 10% of patients with angiomyolipoma (3). This complication is related to the size of the tumor, the grade of the angiogenic component of the tumor, and the presence of tuberous. Herein, we present a catastrophic case of Wunderlich syndrome whose vital signs abruptly worsened, went into hypovolemic shock and required an urgent surgical approach.

Research paper thumbnail of Isolated third ventricle glioblastoma

SpringerPlus, 2016

Introduction: Glioblastoma is the most common and the most malignant type of gliomas. Cerebral he... more Introduction: Glioblastoma is the most common and the most malignant type of gliomas. Cerebral hemispheres are usual locations for gliomas. Isolated third ventricular presentation is very rare for glioblastomas. A new case of isolated third ventricular glioblastoma has been presented in this report. Case description: A 36-year-old woman was admitted to outpatient clinic with headache, blurred vision and confusion. A head CT scan and MRI had showed third ventricular mass lesion with obstructive hydrocephalus. Previous to her admission to our clinic, a ventriculo-peritoneal shunt had been inserted and her hydrocephalus had been relieved to some extent in acute settings. In our clinic, stereotactic biopsy was performed and a second ventriculoperitoneal shunt was inserted from the opposite site. Histopathological diagnosis was glioblastoma. Radiotherapy and chemotherapy were started immediately after the surgery. Patient's hydrocephalus has resolved and she was well at postoperative 6th month. Discussion and evaluation: In differential diagnosis list of the tumors presenting in the third ventricle, there are plenty of tumors such as colloid cyst, meningioma, germinoma, craniopharyngioma, lymphoma, choroid plexus papilloma, subependymal giant cell astrocytoma, chiasmatic and hypothalamic benign astrocytoma. Ring enhancement of this region pathology is a peculiar sign for glioblastoma, yet not pathognomonic. Tumor histology is crucial to yield the final diagnosis. Conclusion: Management of obstructive hydrocephalus, making histopathological diagnosis, starting adjuvant radiotherapy and chemotherapy in isolated third ventricular glioblastomas is a safe and effective approach when we consider malignant nature and intractable progress of glioblastomas.

Research paper thumbnail of Conchal compression: is it a new syndrome?

International journal of clinical and experimental medicine, 2015

To describe the diagnostic criteria and treatments of concha compression syndrome (CCS). Patients... more To describe the diagnostic criteria and treatments of concha compression syndrome (CCS). Patients who reported at least 3 times rhinosinusitis attacks per year were considered in this study. All patients met the diagnosis criteria of rhinosinusitis based on clinical history, showed a nasal septal spur compressing concha on their endoscopic examination and had no findings of rhinosinusitis on their paranasal sinus CT scans but showed concha ondularis. These patients were recognized as suffering from CCS and consequently were surgically treated. 85 patients diagnosed with CCS were included in this study. 25 of the patients were classified as middle, 53 as inferior and 7 as both middle and inferior CCS. Septal spur removal was performed on 16 of the patients whereas the remaining 69 patients received spur removal with septoplasty. After surgery, most of patients' symptoms improved clinically. The importance and the necessity of further investigations into this newly-defined syndrom...

Research paper thumbnail of Tetraventricular central neurocytoma: A rare presentation with imaging.pathologic correlation

Journal of Neurosciences in Rural Practice, 2015

ABSTRACTCentral neurocytoma (CN) is a benign intraventricular neuronal tumor with a favorable pro... more ABSTRACTCentral neurocytoma (CN) is a benign intraventricular neuronal tumor with a favorable prognosis. It accounts approximately 0.25–0.5% of intracranial tumors. In this report, we describe a very rare case of tetraventricular CN with imaging-pathologic correlation, and discuss their atypical features in a location together with treatment options. A 27-year-old man was admitted to the hospital with symptoms of progressive headaches of several months' duration. Magnetic resonance imaging of the brain revealed a well-circumscribed, lobulated intraventricular mass with numerous intratumoral cystlike areas. The mass was located in the enlarged lateral ventricles bilaterally extending to the third and the fourth ventricle. Surgical removal of the 4th ventricle component of the tumor was performed. Histomorphological and immunohistochemical findings of the tumor were consistent with CN. After pathological diagnosis, gamma knife surgery was performed. CN may present with atypical fe...

Research paper thumbnail of Mastoid antral ventilation tube; new treatment modality for reccurent otitis media with effusion and its long term results

International journal of clinical and experimental medicine, 2015

To evaluate the efficiency of mastoid antral ventilation tube (MAVT) treatment in recurrent/chron... more To evaluate the efficiency of mastoid antral ventilation tube (MAVT) treatment in recurrent/chronic otitis media with effusion (OME). 20 OME patients who were unsuccessfully treated with ventilation tube (VT) at least twice, who consented to MAVT and who were followed up at least three years were included in the study group. Control group comprised 10 patients who had the same characteristics and refused to undergo MAVT and underwent VT placement again. Pre-operative and post-operative otomicroscopic, hearing tests, and CT findings were compared between the groups statistically. MAVT was placed into 24 ears of 20 patients. In the control group, VT was placed in 13 ears of 10 patients. Postoperatively, in the study group, one tympanic membrane with adhesion and nine membranes with retraction returned to their anatomic positions after MAVT. In the control group, 2 retracted tympanic membranes returned to normal position. There was significant difference between groups in terms of mast...

Research paper thumbnail of Rare and challenging extra-axial brain lesions: CT and MRI findings with clinico-radiological differential diagnosis and pathological correlation

Diagnostic and Interventional Radiology, 2014

There are many kinds of extra-axial brain tumors and tumor-like lesions, and definitive diagnosis... more There are many kinds of extra-axial brain tumors and tumor-like lesions, and definitive diagnosis is complicated in some cases. In this pictorial essay, we present rare and challenging extra-axial brain lesions including neuroenteric cyst, primary leptomeningeal melanomatosis, isolated dural neurosarcoidosis, intradiploic epidermoid cyst, ruptured dermoid cyst, intraventricular cavernoma, and cavernous hemangioma of the skull with imaging findings and clinico-radiological differential diagnosis, including the pathologic correlation. Familiarity with these entities may improve diagnostic accuracy and patient management.

Research paper thumbnail of Endometrioma of the sigmoid colon presenting with intestinal obstruction

Diagnostic and interventional radiology (Ankara, Turkey), Jan 30, 2017

Research paper thumbnail of Twodetector Computed Tomography Map of Inferior Epigastric Vessels for Percutaneous Transabdominal Intervention Procedures

Balkan Medical Journal, 2014

Research paper thumbnail of CT-angiographic demonstration of hepatic collateral pathways due to superior vena cava obstruction in Behçet disease

Diagnostic and interventional radiology (Ankara, Turkey), 2010

Behçet disease (BD) is a chronic multisystemic inflammatory disorder, mainly characterized by rec... more Behçet disease (BD) is a chronic multisystemic inflammatory disorder, mainly characterized by recurrent oral and genital ulcers, skin lesions, and uveitis. Large vein thrombosis in BD is unusual; when present, it is most frequently seen in the inferior or superior vena cava (SVC). The authors describe an unusual hepatic pseudolesion caused by abnormal focal enhancement through collateral pathways to the liver in two BD patients with SVC occlusion on three-dimensional multi-detector computed tomography, using volume rendering and maximum intensity projection techniques. BD should be suspected in patients presenting a focal increased hepatic enhancement area with collaterals caused by occlusion of the SVC without evidence of a hypercoagulable state or malignant mediastinal or thoracic venous inlet obstruction.

Research paper thumbnail of Magnetic Resonance Imaging of Unusual Neoplasms Related to Foramen of Luschka: A Review for Differential Diagnosis

Indian Journal of Radiology and Imaging

There are many types of neoplasms in or around the foramen of Luschka (FL), and definitive diagno... more There are many types of neoplasms in or around the foramen of Luschka (FL), and definitive diagnosis in some cases requires knowledge of imaging findings. The uncommon and challenging neoplasms with FL involvement considered in this study are exophytic brainstem glioma, primary glioblastoma of the cerebellopontine angle (CPA), primary anaplastic ependymoma of the CPA, choroid plexus papilloma of the FL, solitary FL choroid plexus metastasis, extraskeletal myxoid chondrosarcoma of the jugular foramen, paraganglioma of the jugular foramen, exostosis of the jugular foramen, psammomatous meningioma in the lateral cerebellar medullary cistern, epidermoid tumor of the fourth ventricle, and a hypoglossal schwannoma. These neoplasms may have overlapping clinical and imaging features, but some have relatively distinct imaging features. Knowledge of the key clinical and magnetic resonance imaging features of these unusual lesions with FL involvement is important for radiologists to improve di...

Research paper thumbnail of A rare case of mucosal metastases 14 years after resolution of a primary uveal melanoma

Journal of Clinical Images and Medical Case Reports, 2022

Uveal melanoma has a high metastasis rate. Following the initial diagnosis, up to 50% of patients... more Uveal melanoma has a high metastasis rate. Following the initial diagnosis, up to 50% of patients are affected by late recurrence and gastrointestinal metastasis is found to be one of the least frequent. We report the case of a 47-year-old woman who underwent proton therapy for uveal melanoma. Fourteen years after the initial diagnosis, she presented to the hospital complaining of an enduring gas in stomach. Dark colored, metastatic lesions were discovered in gastric mucosa during endoscopy and hyperintense hepatic lesions were spotted in T1 weighted MR imaging. Long term metastasis is commonly seen in patients with uveal melanoma and its management is more difficult when compared to other melanoma types, hence regular follow-ups are crucial for patient well-being. Keywords: uveal melanoma; gastric metastases; mucosal metastases; gastric mucosa; intraocular tumors.

Research paper thumbnail of Neurosarcoidosis with parenchymal nodules aligned in the temporal lobe

QJM: An International Journal of Medicine, 2021

Granulomas manifest as multiple nodules scattered in both cerebral hemispheres with nodular enhan... more Granulomas manifest as multiple nodules scattered in both cerebral hemispheres with nodular enhancement on post-contrast magnetic resonance imaging in neurosarcoidosis and mimicking metastasis. This is an interesting case report showing that cerebral parenchymal nodules may specially coalesce in a lobe, similar to pulmonary parenchymal involvement, which should be noted in neurosarcoidosis.

Research paper thumbnail of Abdominal variant of Lemierre’s Syndrome in a Patient with Pancreatic Adenocarcinoma

Medeniyet Medical Journal, 2021

Lemierre’s syndrome is an illness characterized by internal jugular vein thrombophlebitis related... more Lemierre’s syndrome is an illness characterized by internal jugular vein thrombophlebitis related to infectious agents, primarily Fusobacterium necrophorum. These bacteria, residing in both the oropharynx and the gastrointestinal tract, may lead to pylephlebitis, a serious condition that could result in the development of hepatic abscesses. This manifestation of the disease is regarded as the abdominal variant of Lemierre’s syndrome. Patients with gastrointestinal malignancies, especially those who undergo surgeries, are susceptible to the abdominal variant of Lemierre’s syndrome. Timely diagnosis is required to avoid the life-threatening complications of the abdominal variant of Lemierre’s syndrome. Diffusion-weighted magnetic resonance imaging (MRI) might be very useful in differentiating this disease from liver metastasis in patients with malignancies. Radiologists and clinicians need to be aware of this challenging condition to prevent misdiagnosis, since prompt treatment is oft...

Research paper thumbnail of Encephalomyelitis associated with Covid-19 infection: case report

British Journal of Neurosurgery, 2020

We describe a COVID-19 patient who presented with persistent headache and anosmia that was relate... more We describe a COVID-19 patient who presented with persistent headache and anosmia that was related to viral encephalomyelitis with acute lesions on MRI in both the brain and upper cervical cord.

Research paper thumbnail of Neonatal lower GIS obstruction with typical radiographic findings: Meconium Ileus

Türk Radyoloji Dergisi/Turkish Journal of Radiology, 2018

Meconium ileus is a lower gastrointestinal obstruction syndrome due to the impaction of abnormall... more Meconium ileus is a lower gastrointestinal obstruction syndrome due to the impaction of abnormally thick and sticky meconium in the terminal ileum. It is most often early manifestation of cystic fibrosis. This is a case of surgically proved meconium ileus, whose genetic profile is negative for cystic fibrosis. It is important to differentiate neonatal lower gastrointestinal obstruction and also meconium related disorders due to early treatment and better prognosis. Contrast enhanced fluoroscopic imaging is the primary and indispensable radiologic method for this purpose. We present our case with typical fluoroscopic findings of meconium ileus, along with literature review of other meconium related disorders.

Research paper thumbnail of Endometriosis in an Episiotomy Scar: Case Report

Türk Üreme Tıbbı ve Cerrahisi Dergisi, 2018

Research paper thumbnail of A Rare Cause and Complication of Acute Gastric Dilatation: Superior Mesenteric Artery Syndrome and Perforation

The Eurasian journal of medicine, 2018

Research paper thumbnail of Successful Endovascular Management of a Transplant Renal Artery Pseudoaneurysm Complicated With Arterioureteral Fistula

Progress in transplantation (Aliso Viejo, Calif.), 2017

We report a case of renal artery pseudoaneurysm at the anastomosis site complicated with arteriou... more We report a case of renal artery pseudoaneurysm at the anastomosis site complicated with arterioureteral fistula (AUF) in a 57-year-old kidney transplant recipient who presented with intermittent massive hematuria at one month post-transplant. We successfully treated the pseudoaneurysm and AUF with endovascular covered stent implantation. The diagnosis of AUF is rare and it is a condition that occurs in patients with previous pelvic or vascular surgery, chronic ureteral catheterization and radiotherapy. This diagnosis requires the expertise of the urologist, vascular surgeon and interventional radiologist. The fistula most often occur in the iliac arteries and are often associated with pseudoaneurysms or abscesses. Angiography and ureteral contrast studies (antegrade or retrograde pyelography) are the most valuable diagnostic tools. Treatment of AUF via endovascular approach using covered stents is effective and safe, and is becoming the reference treatment in AUFs.

Research paper thumbnail of Imaging Findings of the Unusual Presentations, Associations and Clinical Mimics of Acute Appendicitis

The Eurasian journal of medicine, 2017

There are many kinds of unusual presentations or associations and clinical mimics of acute append... more There are many kinds of unusual presentations or associations and clinical mimics of acute appendicitis, and definitive diagnosis requires knowledge of the imaging findings in some cases. The unusual presentations and associations of acute appendicitis included in this study are perforated appendicitis, acute appendicitis occurring in hernias, acute appendicitis with cystic endosalpingiosis, intussusception of appendix, and acute appendicitis with pregnancy. We also present uncommon gastrointestinal, urinary and gynecologic clinical mimics of acute appendicitis including anomalous congenital band, duplication cysts, giant Meckel's diverticulitis, inflammatory fibroid polyp, renal artery thrombosis, spontaneous urinary extravasation and OHVIRA syndrome. Familiarity with these entities may improve diagnostic accuracy and enable the quickest and most appropriate clinical management.

Research paper thumbnail of Coincidence of Polysplenia, Kartagener Syndrome, Dorsal Pancreas Agenesis, and Polycystic Kidney Disease in an Adult

The Eurasian journal of medicine, 2017

Here we present the case of an adult male patient with the anomalies of polysplenia, Kartagener s... more Here we present the case of an adult male patient with the anomalies of polysplenia, Kartagener syndrome, dorsal pancreas agenesis, and adult polycystic kidney disease. Familiarity with this extremely rare coincidence may improve diagnostic accuracy and patient management.

Research paper thumbnail of A Rare Cause of Acute Abdomen Due to Hemorrhage of Renal Mass: Wunderlich Syndrome

Journal of Emergency Medicine Case Reports, 2017

Renal angiomyolipomas are rare benign lesions of the kidney with an incidence between 0.1% and 0.... more Renal angiomyolipomas are rare benign lesions of the kidney with an incidence between 0.1% and 0.22% (1). They are composed of abnormal vasculature, smooth muscle, and adipose tissue. They are more likely to be symptomatic if they are larger than 4 cm, and present a history of flank pain, a palpable mass, and rarely haematuria. Also, they are most frequent etiology of Wunderlich syndrome, which is an emergency medical condition that refers to spontaneous nontraumatic bleeding confined to the perinephric space (2). Although benign, their rich neovascularization has a tendency for spontaneous rupture with consequent hemorrhage, which in some cases can be life threatening. Significant perinephric hemorrhage may occur in approximately 10% of patients with angiomyolipoma (3). This complication is related to the size of the tumor, the grade of the angiogenic component of the tumor, and the presence of tuberous. Herein, we present a catastrophic case of Wunderlich syndrome whose vital signs abruptly worsened, went into hypovolemic shock and required an urgent surgical approach.

Research paper thumbnail of Isolated third ventricle glioblastoma

SpringerPlus, 2016

Introduction: Glioblastoma is the most common and the most malignant type of gliomas. Cerebral he... more Introduction: Glioblastoma is the most common and the most malignant type of gliomas. Cerebral hemispheres are usual locations for gliomas. Isolated third ventricular presentation is very rare for glioblastomas. A new case of isolated third ventricular glioblastoma has been presented in this report. Case description: A 36-year-old woman was admitted to outpatient clinic with headache, blurred vision and confusion. A head CT scan and MRI had showed third ventricular mass lesion with obstructive hydrocephalus. Previous to her admission to our clinic, a ventriculo-peritoneal shunt had been inserted and her hydrocephalus had been relieved to some extent in acute settings. In our clinic, stereotactic biopsy was performed and a second ventriculoperitoneal shunt was inserted from the opposite site. Histopathological diagnosis was glioblastoma. Radiotherapy and chemotherapy were started immediately after the surgery. Patient's hydrocephalus has resolved and she was well at postoperative 6th month. Discussion and evaluation: In differential diagnosis list of the tumors presenting in the third ventricle, there are plenty of tumors such as colloid cyst, meningioma, germinoma, craniopharyngioma, lymphoma, choroid plexus papilloma, subependymal giant cell astrocytoma, chiasmatic and hypothalamic benign astrocytoma. Ring enhancement of this region pathology is a peculiar sign for glioblastoma, yet not pathognomonic. Tumor histology is crucial to yield the final diagnosis. Conclusion: Management of obstructive hydrocephalus, making histopathological diagnosis, starting adjuvant radiotherapy and chemotherapy in isolated third ventricular glioblastomas is a safe and effective approach when we consider malignant nature and intractable progress of glioblastomas.

Research paper thumbnail of Conchal compression: is it a new syndrome?

International journal of clinical and experimental medicine, 2015

To describe the diagnostic criteria and treatments of concha compression syndrome (CCS). Patients... more To describe the diagnostic criteria and treatments of concha compression syndrome (CCS). Patients who reported at least 3 times rhinosinusitis attacks per year were considered in this study. All patients met the diagnosis criteria of rhinosinusitis based on clinical history, showed a nasal septal spur compressing concha on their endoscopic examination and had no findings of rhinosinusitis on their paranasal sinus CT scans but showed concha ondularis. These patients were recognized as suffering from CCS and consequently were surgically treated. 85 patients diagnosed with CCS were included in this study. 25 of the patients were classified as middle, 53 as inferior and 7 as both middle and inferior CCS. Septal spur removal was performed on 16 of the patients whereas the remaining 69 patients received spur removal with septoplasty. After surgery, most of patients' symptoms improved clinically. The importance and the necessity of further investigations into this newly-defined syndrom...

Research paper thumbnail of Tetraventricular central neurocytoma: A rare presentation with imaging.pathologic correlation

Journal of Neurosciences in Rural Practice, 2015

ABSTRACTCentral neurocytoma (CN) is a benign intraventricular neuronal tumor with a favorable pro... more ABSTRACTCentral neurocytoma (CN) is a benign intraventricular neuronal tumor with a favorable prognosis. It accounts approximately 0.25–0.5% of intracranial tumors. In this report, we describe a very rare case of tetraventricular CN with imaging-pathologic correlation, and discuss their atypical features in a location together with treatment options. A 27-year-old man was admitted to the hospital with symptoms of progressive headaches of several months' duration. Magnetic resonance imaging of the brain revealed a well-circumscribed, lobulated intraventricular mass with numerous intratumoral cystlike areas. The mass was located in the enlarged lateral ventricles bilaterally extending to the third and the fourth ventricle. Surgical removal of the 4th ventricle component of the tumor was performed. Histomorphological and immunohistochemical findings of the tumor were consistent with CN. After pathological diagnosis, gamma knife surgery was performed. CN may present with atypical fe...

Research paper thumbnail of Mastoid antral ventilation tube; new treatment modality for reccurent otitis media with effusion and its long term results

International journal of clinical and experimental medicine, 2015

To evaluate the efficiency of mastoid antral ventilation tube (MAVT) treatment in recurrent/chron... more To evaluate the efficiency of mastoid antral ventilation tube (MAVT) treatment in recurrent/chronic otitis media with effusion (OME). 20 OME patients who were unsuccessfully treated with ventilation tube (VT) at least twice, who consented to MAVT and who were followed up at least three years were included in the study group. Control group comprised 10 patients who had the same characteristics and refused to undergo MAVT and underwent VT placement again. Pre-operative and post-operative otomicroscopic, hearing tests, and CT findings were compared between the groups statistically. MAVT was placed into 24 ears of 20 patients. In the control group, VT was placed in 13 ears of 10 patients. Postoperatively, in the study group, one tympanic membrane with adhesion and nine membranes with retraction returned to their anatomic positions after MAVT. In the control group, 2 retracted tympanic membranes returned to normal position. There was significant difference between groups in terms of mast...

Research paper thumbnail of Rare and challenging extra-axial brain lesions: CT and MRI findings with clinico-radiological differential diagnosis and pathological correlation

Diagnostic and Interventional Radiology, 2014

There are many kinds of extra-axial brain tumors and tumor-like lesions, and definitive diagnosis... more There are many kinds of extra-axial brain tumors and tumor-like lesions, and definitive diagnosis is complicated in some cases. In this pictorial essay, we present rare and challenging extra-axial brain lesions including neuroenteric cyst, primary leptomeningeal melanomatosis, isolated dural neurosarcoidosis, intradiploic epidermoid cyst, ruptured dermoid cyst, intraventricular cavernoma, and cavernous hemangioma of the skull with imaging findings and clinico-radiological differential diagnosis, including the pathologic correlation. Familiarity with these entities may improve diagnostic accuracy and patient management.

Research paper thumbnail of Endometrioma of the sigmoid colon presenting with intestinal obstruction

Diagnostic and interventional radiology (Ankara, Turkey), Jan 30, 2017

Research paper thumbnail of Twodetector Computed Tomography Map of Inferior Epigastric Vessels for Percutaneous Transabdominal Intervention Procedures

Balkan Medical Journal, 2014

Research paper thumbnail of CT-angiographic demonstration of hepatic collateral pathways due to superior vena cava obstruction in Behçet disease

Diagnostic and interventional radiology (Ankara, Turkey), 2010

Behçet disease (BD) is a chronic multisystemic inflammatory disorder, mainly characterized by rec... more Behçet disease (BD) is a chronic multisystemic inflammatory disorder, mainly characterized by recurrent oral and genital ulcers, skin lesions, and uveitis. Large vein thrombosis in BD is unusual; when present, it is most frequently seen in the inferior or superior vena cava (SVC). The authors describe an unusual hepatic pseudolesion caused by abnormal focal enhancement through collateral pathways to the liver in two BD patients with SVC occlusion on three-dimensional multi-detector computed tomography, using volume rendering and maximum intensity projection techniques. BD should be suspected in patients presenting a focal increased hepatic enhancement area with collaterals caused by occlusion of the SVC without evidence of a hypercoagulable state or malignant mediastinal or thoracic venous inlet obstruction.