Background and Objective: Bladder cancer (BC) is the ninth most common malignancy worldwide. Squamous cell carcinoma (SqCC), a rare histological variant, accounts for approximately 2–5% of all BC cases. Compared to urothelial carcinoma, the predominant subtype, research on SqCC remains limited and shows inconsistent findings regarding prognosis. This study aimed to compare survival outcomes between patients with SqCC and those with pure urothelial carcinoma (PUC). Methods: This retrospective, observational study analyzed pathology reports from 2549 transurethral resections of bladder tumors and 632 cystectomies performed at our institution between 1 December 2010 and 31 December 2023. Following pathological re-evaluation, 33 patients with SqCC and 132 with PUC were identified. After 1:3 propensity score matching, 20 patients with SqCC and 58 with PUC were included in the final analysis. Demographic, clinicopathological features, and survival outcomes were compared between groups. Results: The median follow-up was 2.31 years (range: 0.17–13.50). No significant differences in baseline demographic or clinical characteristics were observed, except for the type of surgery. Kaplan–Meier analysis demonstrated no significant differences in disease-free survival (DFS; p = 0.961) or overall survival (OS; p = 0.847) between SqCC and PUC groups. Multivariate Cox regression analysis identified T stage, nodal involvement, and adjuvant chemotherapy (CT) as independent predictors of DFS, while sex and metastasis at diagnosis were significant predictors of OS. Conclusion: Survival outcomes (DFS and OS) did not significantly differ between patients with SqCC and patients with PUC. Prognosis was more closely associated with disease stage at diagnosis, sex, and adjuvant CT. Further large-scale studies are warranted.

Ganglioneuromas are rare, benign tumors arising from neuroblastic cells in the autonomic sympathetic nervous system. While generally considered indolent, limited case reports suggest their potential for regional metastasis. This retrospective study analyzed the clinical, demographic, and pathological features of 25 adult patients diagnosed with ganglioneuroma at Bursa Uludag University, Faculty of Medicine, between April 2007 and November 2023. The cohort comprised 18 females (72%) and seven males (28%), with a median age of 42 years (range: 19–79). Tumors were most commonly located in the abdomen (64%), followed by the thoracic (24%) and head and neck regions (12%), with the adrenal gland being the primary site in 32% of cases. Symptoms were present in 56% of patients, including pain, vision loss, hypertension, and palpable masses, while the remaining were asymptomatic. Surgical resection was performed in 92% of cases, with a median tumor size of 7.5 cm (1.5–18 cm). Median follow-up time was 88.3(16.2 - 217.8) months. Regional lymph node metastases were identified in 8% of patients, but no distant metastases or recurrences were observed during follow-up. These findings, including the novel observation of regional metastases, contribute valuable insights to the limited literature on ganglioneuromas. Despite its benign nature, this study highlights the potential for lymph node metastasis. However, the relationship between lymph node metastasis and recurrence has not been documented. In this context, further research is essential to better understand the risk factors, tumorigenesis, and the optimal management strategies for this rare tumor.

Background: Approximately 15–20% of early-stage breast cancers overexpress HER2, which is associated with an increased risk of recurrence. Although adjuvant anti-HER2 therapies have significantly improved patient outcomes, the optimal treatment strategy remains uncertain, particularly for patients with small, lymph node-negative tumors, where concerns about potential overtreatment and toxicity persist. The objective of this study was to evaluate overall survival (OS), recurrence-free survival (RFS), and treatment-related neuropathy in patients with early-stage HER2-positive breast cancer treated with adjuvant trastuzumab and paclitaxel. Methods: A total of 129 patients, aged 18 to 75 years, diagnosed with early-stage HER2-positive breast cancer, were retrospectively analyzed in this multicenter study. All patients had received adjuvant treatment with trastuzumab and paclitaxel (TH regimen) between November 2016 and July 2023. The study involved the collection of demographic information, pathological features, and treatment-related details. Overall survival (OS) was defined as the primary study endpoint, while recurrence-free survival (RFS), disease control rate (DCR), and treatment-related neuropathy were evaluated as secondary outcomes. Results: The median follow-up time was 70.9 months. The 2-year and 5-year OS rates were 95.3%, and the 5-year RFS rate was 96.8%. No statistically significant differences in OS or RFS were observed in relation to tumor size (T1 vs. T2), hormone receptor status, Ki-67 index, tumor grade, or the use of adjuvant endocrine or radiotherapy (all p > 0.05). Neuropathy developed in 53.5% of patients, mostly grade 1. Conclusions: Adjuvant TH therapy shows favorable long-term outcomes in early-stage HER2-positive breast cancer.

Pilomatrix carcinoma is a rare, locally aggressive malignant adnexal tumor derived from hair follicle matrix cells. Although secondary malignancies are a well-known concern in Hodgkin lymphoma (HL) survivors, the occurrence of pilomatrix carcinoma in this setting is infrequent. We present the case of a 62-year-old man who was treated for Stage 1 Nodular Sclerosing Classical HL in 2018 with ABVD chemotherapy and radiotherapy. In January 2024, while in remission, he presented with a mass on the right posterior crus, distinct from the previous radiation field. Excision and histopathologic examination revealed pilomatrix carcinoma. Diagnosis was confirmed by immunohistochemistry, which showed a high Ki-67 index, nuclear beta-catenin positivity, and BerEP4 negativity. Owing to the aggressive nature of the tumor, wide re-excision and inguinal lymph node sampling were performed. This case report discusses the diagnostic challenges of this rare tumor and highlights its emergence as a second primary malignancy in a HL survivor, potentially linked to prior chemotherapy and systemic immune dysregulation.

Urinary tract infections (UTIs) are common complications after kidney transplantation, significantly affecting patient and graft outcomes. This study presents a thorough examination of the epidemiological features, causative pathogens, and antibiotic treatment patterns among kidney transplant recipients. A retrospective review was conducted involving 550 kidney transplant patients at a single transplant center, between January 2006 and May 2019. Patient demographics, clinical data, microbiological findings, and antibiotic susceptibility results were systematically analyzed. Among 550 transplant patients, at least one episode of UTI was observed in 200. Out of 633 UTI episodes identified, Escherichia coli was the most common causative microorganism, representing 64.9%. Among these, ESBL (Extended-Spectrum Beta-Lactamase) positivity was found in 51.6%. UTIs continue to be a common and challenging complication among kidney transplant recipients. Implementing specific preventive strategies and maintaining careful antibiotic policies are essential to minimize risks and enhance patient outcomes. The notably higher rate of ESBL positivity in UTI cases, which exceeds typical levels, aligns with the rising trend of antibiotic resistance observed both locally and globally in recent years. This finding serves as a crucial warning, prompting a review of antibiotic selection practices.

Infection is the most common reason for admission to the emergency department in the early period after transplantation. Urinary tract infections (UTIs) in adult kidney transplant patients are common. Their incidence is significantly higher than in the general population.1 The majority of sepsis cases in this period are composed of UTIs.2 While mild UTIs generally do not affect graft function, acute pyelonephritis observed in the post-transplant period causes a decrease in graft function and an increase in mortality.3 In the literature, a small amount of data has been published regarding the incidence, epidemiological features, and risk factors of UTIs in kidney transplant recipients. In this retrospective study, we evaluated the data of 550 patients who underwent kidney transplantation between January 2006 and May 2019 at our center and analyzed UTIs' characteristics. Among 550 recipients, 633 episodes were detected in 200 patients (36.4%). Recurrent infection was encountered in 74 (37%) of 200 patients. We determined 1 episode in 63 (31.5%), 2 episodes in 39 (19.5%), 3 episodes in 31 (15.5%), 4 episodes in 14 (7%), 5 episodes in 10 (5%), 6 episodes in 8 (4%), and 7 or more episodes in 35 (17.5%). While 48.3% (n=306) of 633 episodes were asymptomatic bacteriuria, 51.6% (n=327) was symptomatic. The risk factors for UTI were female gender, the advanced age of transplant and advanced donor age, long-term dialysis period before transplant, prolonged urinary catheterization and hospitalization time after transplant, cytomegalovirus infection, vesicoureteral reflux, and neurogenic bladder history. At the survival analysis, a transplant from living donor, female gender, use of tacrolimus, mycophenolate mofetil and corticosteroid combination as maintenance immunosuppressive therapy, preemptive transplant compared to patients receiving peritoneal dialysis was found to be associated with longer survival; advanced age of transplant, obesity, delayed graft function, acute rejection, diabetes mellitus and a history of cytomegalovirus infection was also associated with a shorter life span. Escherichia coli (64.9%) and Klebsiella pneumonia (51.6%) were the most common causative microorganisms, and ESBL (Expanded Spectrum Beta-Lactamase) was positive in 19.9% and 67.5% of them, respectively. Similarly, female gender, the advanced age of transplant, prolonged catheterization time, history of vesicoureteral reflux, neurogenic bladder, acute rejection, and deceased donor were dependent risk factors for developing of UTI in transplant recipients in other studies,4-6 but not body mass index, history of diabetes mellitus, dialysis type and duration, primary kidney disease, donor type, delayed graft function, and history of acute rejection in another study.7 UTI frequency in the female gender increases due to anatomical differences such as the shorter urethra compared to men and its relative proximity to the perianal region and vulva, as in the general population. Age-related changes in the urinary tract and existing additional diseases are important factors that predispose to bacterial colonization. Prolonged urinary catheterization and hospitalization durations facilitate pathogen entry into sterile body parts in the post-operative period. Immunosuppression, frequent hospitalizations, and surgical interventions increase the risk of nosocomial infections in dialysis patients. A history of vesicoureteral reflux facilitating bacterial invasion and a neurogenic bladder causing urinary stasis poses a UTI risk. Hospitalizations for septicemia are most commonly associated with UTI.8 In our cohort, antibiotics in the carbapenem group, started in more than half of the episodes. There is an increase in trimethoprim/sulfamethoxazole, ciprofloxacin and ceftazidime resistance in Klebsiella species.9 Although the microorganism spectrum in the studies is similar all world, ESBL positivity is noticeably higher than the average in UTI episodes is an observation in parallel with the increasing antibiotic resistance both in our country and in the world in recent years. This observation was considered as a cautionary finding for the review of antibiotic selection preferences in our clinic. Finally, UTIs being a threat to graft and patient survival in the post-transplant period should be treated effectively by carefully evaluating risk factors.