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    Cardiac metastasis of thyroid cancer
    (2009) Bilgi, O.; Haholu, A.; Kardeşo?lu, E.; Türken, O.; Kandemir, E.G.; Karagöz, B.
    Anaplastic thyroid carcinomas are very aggressive cancers and metastasize frequently to the lungs and pleura. The cardiac metastases of thyroid cancers are rare. The diagnosis before the death is rare. We present a case of anaplastic thyroid carcinoma with metastatic involvement of the heart. It was presented with atrial fibrillation. The echocardiography demonstrated a solid mass in interventricular septum. One week later the patient died of heart failure. We call attention of clinicians that during the follow up of thyroid cancer such arrythmias may be the harbinger of a cardiac metastasis.
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    Hyperammonemic encephalopathy in a patient with primary hepatic neuroendocrine carcinoma.
    (Springer Link, 2009) Başekim, C.; Haholu, A.; Karagöz, B.; Bilgi, O.; Özgün, A.; Küçükardalı, Y.; Narin, Y.; Yazgan, Y.; Kandemir, E. G.
    A 53-year-old male patient was admitted to our hospital with abdominal pain in the right upper quadrant. There was no change in laboratory investigations other than a slight increase in serum levels of alkaline phosphatase (ALP), alanine aminotransferase (ALT), and gamma glutamyl transferase (GGT). Computed tomography (CT) of the abdomen showed multiple hepatic nodular lesions in the liver. Tru-cut biopsy of the lesions was reported as well-differentiated neuroendocrine carcinoma. The patient received sandostatin treatment. After a few days, the patient was hospitalized in the intensive care unit with disturbance of consciousness and clinical features suggestive of encephalopathy. Serum ammonia level was found highly elevated. After the treatment with L-ornithine-L-aspartate, a remarkable improvement in the level of patient's sensorium occurred as well as a reduction in serum ammonia level within a few days. Transarterial chemoembolization (TACE) was performed one week later. The patient's condition began to worsen along with increase in serum ammonia level and he died because of hyperammonemic encephalopathy. There are case reports of hyperammonemia with some malignancies such as multiple myeloma, plasma cell leukemia, and leiomyosarcoma, or in some patients who have received chemotherapy. This case may suggest an association between hyperammonemia and neuroendocrine tumors.
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    Hyperbaric oxygen therapy does not potentiate doxorubicin-induced cardiotoxicity in rats.
    (Wiley Online Library, 2008) Karagöz, B.; Süleymanoğlu, S.; Uzun, G.; Bilgi, O.; Aydınöz, S.; Haholu, A.; Önem, Y.; Kandemir, E. G.
    Abstract: The current use of doxorubicin is regarded as an absolute contraindication for hyperbaric oxygen (HBO2) therapy because of the increased risk of cardiotoxicity. The aim of this study was to investigate whether additional exposure to HBO2 during the course of doxorubicin treatment would further increase the cardiotoxicity of doxorubicin in rats. Female Wistar rats were treated with either HBO2 (n = 10) or doxorubicin (n = 8) or a combination of both treatments (n = 10) for 4 consecutive weeks and followed up for an additional 4 weeks. Cardiomyopathy was evaluated using two-dimensional and M-mode echocardiography at baseline, at the fourth, sixth and eighth weeks, and by histopathological investigation of the rat hearts at the eighth week. Doxorubicin treatment significantly reduced ejection fraction and fractional shortening (P < 0.001) and caused severe histopathological injury (P < 0.05) indicating development of cardiotoxicity. Although the combination of doxorubicin and HBO2 also markedly reduced ejection fraction and fractional shortening (P < 0.001), this reduction was significantly less than that of doxorubicin treatment (P < 0.05). HBO2 therapy also attenuated doxorubicin-induced histopathological changes in rat hearts (P < 0.05). HBO2 alone did not alter echocardiographic parameters or histopathological findings (P > 0.05). In conclusion, HBO2 therapy does not potentiate doxorubicin-induced cardiotoxicity in rats. Cardioprotection conferred by HBO2 against doxorubicin warrants further investigation.