Encapsulating peritoneal sclerosis (EPS) is a rare cause of intestinal obstruction which is characterized by fibrotic encapsulation of the bowel. Although its pathogenesis is still not clear, many etiological factors have been stated. In this report, we present a 26-year old woman with peritoneal dialysis related EPS. Because of the unresolving intestinal obstructive symptoms, she underwent surgical intervention in which the thick dense whitish membranous sac was excised from the surrounding intestine along with adhesiolysis. She recovered uneventfully. She is symptom-free on the eight months of follow-up. EPS should be born in mind as a complication of the long term peritoneal dialysis in patients with progressive obstructive ileus and recurrent peritonitis. Its treatment either medically or surgically varies depending on the stage of this entity. Early identification of EPS is important in order to achieve better prognosis.

Thyroidectomy is the most common cause of hypocalcemia. Preservation of parathyroid glands in situ is essential in preventing this complication. The aims of our study were to review patients who underwent parathyroid gland autotransplantation during thyroidectomy, and to compare hypocalcemia rates in patients with and without autotransplantation. Parathyroid gland autotransplantation was performed in 43 (7.9%) of 543 patients who underwent thyroidectomy between 2008 and 2012. Forty-four parathyroid glands were autotransplanted in 43 patients, including 36 women and 7 men. The median age was 55 (range: 30 to 68). The most common cause of autotransplantation was vascular comprise of the parathyroid gland. Early postoperative hypocalcemia developed in 37% of patients with autotransplantation, and none developed permanent hypocalcemia. Transient and permanent hypocalcemia rates were 9.6% and 0.4% in patients without autotransplantation, respectively. The risk of transient hypocalcemia was significantly high in patients with parathyroid autotransplantation (p<0.001). There was no difference between the two groups in terms of permanent hypocalcemia (p=0.156). Despite meticulous dissection, parathyroid glands can be devascularized or removed inadvertently during thyroidectomy. Parathyroid autotransplantation is the best method to maintain parathyroid gland function. Although the risk of transient hypocalcemia is increased following parathyroid autotransplantation, long-term results are satisfactory.

Gossypiboma which cause medico-legal implications is a heritage of previous surgery. In this study, we present two cases of gossypiboma mimicking intraabdominal malignancy. Case 1: A 28-year-old woman presented with an epigastric mass measuring 10 cm in diameter and a history of open cholecystectomy performed three years ago. Radiological exams revealed a cystic mass at the lesser sac and suggested serous cystadenocarcinoma. Case 2: A 36-year-old female patient with a history of two caesarean sections had a mass in the left lower quadrant. Radiological imaging showed tumoral mass near the left ovary. The exact diagnosis of gossypiboma were achieved by laparotomy and pathological examination in both cases. Gossypibomas usually present with nonspecific symptoms and appear many years after surgery. Therefore, its preoperative diagnosis is very difficult. High degree of suspicion is essential and it should be considered in the differential diagnosis of intraabdominal masses in patients who have previously undergone surgery.

Objective: To determine the associated risk factors for isolated liver metastasis in breast cancer patients and to detect the prognostic factors related to survival. Study Design: Analytical study. Place and Duration of the Study: Department of General Surgery, The University of Health Sciences, Istanbul, Turkiye, from January 2011 to November 2020. Methodology: Patients with breast cancer liver metastasis who experienced surgery were retrospectively analysed for breast cancer and metastases -related characteristics. Descriptive statistical methods were used in the evaluation of data. Survival analyses were estimated by the Kaplan -Meier method. Log -rank and univariable Cox regression tests were utilised to search for prognostic factors' impact on survival. Results: Out of 12 patients, 11 had recurrent disease after a median of 36 months of disease -free survival (DFS) and one patient had de novo metastasis. Grade 3 tumours and increased expression of Ki-67 had a negative effect on DFS. The median follow-up period was 66 months. Survival analysis showed 2- and 3 -year progression -free survival (PFS); overall survival rates were 82%, 69%, 92%, and 82%, respectively. Development of liver metastasis in 3 years following breast cancer treatment was linked to worse PFS (p = 0.040). Conclusion: Long-term survival is possible for breast cancer survivors with liver metastasis. Disease -free interval is an important determinant. Longer progression -free survival was detected in patients who had developed metastasis after three years of breast cancer treatment.

Angiotropism/perivascular invasion (PVI) is an emerging topic in various types of cancer, with studies primarily focusing on melanoma. However, limited data are available on the significance of PVI in breast cancer. This study aimed to assess the prognostic significance of PVI in breast cancer and its correlation with traditional clinicopathological prognostic parameters. A total of 150 patients with breast cancer diagnosed between July 2020 and January 2022 were included. Clinicopathological data were retrieved from the hospital records. The presence of PVI was evaluated on hematoxylin&eosin stained slides, and the association between PVI and clinicopathological parameters was statistically analyzed. A p-value of <0.05 was regarded as statistically significant. All patients were female. The mean age was 54.0±13.6 years (range 26-97 years). PVI was significantly more common in patients with ≥2.5 cm tumors and the absence of PVI showed a significant correlation with a lower histologic grade (p=0.004 and p=0.040, respectively). Lymphovascular invasion (LVI) and perineural invasion (PNI) were also significantly more frequent in tumors with PVI (p=0.001 and 0.02, respectively). There was a statistically significant association between the absence of both PVI and extranodal extension (ENE) (p=0.035). The specific role of PVI in different types of cancer has not yet been clarified. Our findings showed that PVI was significantly associated with tumor size, histological grade, LVI, PNI, and ENE, all of which are well-known negative prognostic factors in breast cancer. The presence of PVI is a promising topic in breast cancer research, and the PVI status in pathology reports may help oncologists perform better risk assessments for patients with breast carcinoma.

Background and Objectives: Among breast cancer molecular types, HER2 positive and triple negative (TN) subtypes have the highest likelihood of pathological complete response (pCR), which is a surrogate marker for reduced recurrence and improved patient survival after neoadjuvant systemic treatment (NST). Preoperative pathological identification of these exceptional responders is a new era. Therefore, we aimed to determine the accuracy of trucut biopsy in identifying the exceptional responders in selected molecular subtypes of breast cancer patients. Materials and Methods: This two-centre, observational, single-arm, prospective, pilot study was conducted between January and September 2024. The patients with TN or HER2 positive breast cancer whose breast tumour had completely disappeared on the radiological assessment including MRI after neoadjuvant therapy were enrolled. To assess neoadjuvant treatment response, a standardised biopsy protocol was used, consisting of 10 samples from the marked tumour area per patient by 12 G core needle. Then, all patients underwent surgery. The pathological results of both postchemo-presurgical biopsy and surgical breast specimen were compared. Results: The study included 20 patients. The mean age of the patients was 47.3 years. The median tumour size at diagnosis was 23.1 mm. All biopsy results were concordant with the findings of surgical specimen. Seventeen patients had a complete response. The remaining 3 patients had residual disease. Conclusions: Along with thorough patient selection, post-chemo radiological assessment and the reliable biopsy technique are the key points in accurately predicting response to neoadjuvant treatment. If an image-guided core biopsy confirms elimination of tumour tissue at the marked tumour area with a radiological complete response on MRI after NST in breast cancer patients with selected molecular subtypes, these may be suitable patients as exceptional responders in whom we can omit breast surgery.