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Resumen Objetivo El objetivo del presente articulo fue identificar el valor pronostico del indice nutricional pronostico (INP) basal en pacientes con cancer de prostata resistente a la castracion metastasico (CPRCm) tratados con acetato de abiraterona o enzalutamida. Metodos Se incluyeron 101 pacientes de CPRCm. El INP se calculo mediante la formula 10 × valor de albumina serica (g/dl) + 0,005 × recuento total de linfocitos (mm 3 ). Se utilizo el analisis ROC para determinar el valor pronostico del INP. Resultados El valor de corte estadisticamente significativo para el INP fue 46,62. La respuesta inicial del PSA y la cinetica del PSA (respuesta precoz por PSA y respuesta por PSA del 30-50-90% en cualquier momento) fueron mucho mejores en el grupo INP > 46,62 que en el grupo INP ≤ 46,62 (p 46,62 fue un predictor independiente de la SLP por PSA (HR: 0,42; p Conclusion El INP es un marcador pronostico util e independiente para los pacientes con CPRCm tratados con acetato de abiraterona o enzalutamida. El uso del INP previo al tratamiento puede ayudar a los medicos en la prediccion de la supervivencia y en la eleccion de acetato de abiraterona o enzalutamida.

Transverse colon cancer (TCC) is a rare condition that accounts for 10% of all colon cancers. TCC was accepted more likely right-sided colon cancers. We aimed to investigate whether TCC differs from other colon tumors by using clinical, pathological, and molecular prognostic factors known to be important in colon cancer and if it differs in its own anatomical structure. We evaluated local and locally advanced TCC patients between 2007 and 2020 years for demographics data, symptoms, treatment status, and histopathological and molecular features. Overall, 107 TCC patients were included in this study. According to the molecular data analysis of 44, 35, and 23 patients for MSI, RAS, and BRAF status, respectively, 7 (15.9%) were MSI-H, 13 (37.1%) were RAS mutant, and 11 (47.8%) had BRAF V600E mutation. The median follow-up time was 31.5 months. Median disease-free survival (DFS) was 5.19 months, and median OS was 88.3 months for the whole study population. The tumor stage was the most significant prognostic factor for DFS and OS. Although BRAF mutation was not a significant marker for DFS, it was an independent prognostic marker for OS (HR 3.90 95% CI 1.42–10.7). There were no statistically significant differences between proximal two-thirds and distal one-third tumor location. TCC has molecular features and prognostic factors more likely RCC and no differences between proximal and distal sub-parts. BRAF V600E mutation status is an independent predictor of survival even in the early stages of TCC.

Purpose: We aimed to identify the prognostic and predictive values of post-treatment prognostic nutritional index (PNI) and PNI dynamics in nasopharyngeal cancer patients (NPC) in this study.Methods: 107 non-metastatic NPC patients were included. PNI was calculated by using the following formula: [10 x serum albumin value (gr/dL)] + [0.005 x total lymphocyte count (per mm3)]. ROC analysis was used for determining prognostic PNI values and univariate and multivariate statistical analyses for prognostic characterization of PNI. Results: The statistically significant cut-off values for pre-and post-treatment PNI were 50.65 and 44.75, respectively. Of the pre-treatment PNI analysis, PNI≤50.65 group had shorter loco-regional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS), and overall survival (OS). Furthermore, for post-treatment PNI analysis, PNI≤44.75 group had shorter LRRFS and OS. In univariate analysis, only pre-treatment PNI was associated with LRRFS and DMFS, while pre-and post-treatment PNI were both associated with OS. In multivariate analysis, both PNI were independent prognostic markers for OS. In the combined analysis, pre-and post-treatment PNI, differences between the groups were statistically significant, and the PNI dynamics was an independent prognostic indicator for OS. Conclusion: PNI is a useful, independent prognostic marker for non-metastatic NPC patients. It is used for either pre-or post-treatment patients. Furthermore, changes in pre-treatment PNI value after curative treatment is a significant indicator for OS.

Objective: To evaluate clinical and demographic characteristics and the results of cytotoxic treatments of KRASG12C, KRASother, and next-generation sequencing (NGS) panel negative patients. Methods: NGS data of 1264 patients with non-small cell lung cancer were retrospectively evaluated. Among these patients, the mutation distributions of 1081 patients with metastatic lung adenocarcinoma were analyzed. A total of 150 patients with negative NGS panel or mutant KRAS followed up in our clinic were included. Clinical features, overall survival, first-line chemotherapy responses, and progression-free survival of NGS panel negative, KRASG12C, and KRASother groups were compared. Results: In 1081 patients who underwent NGS from tumor tissue with the diagnosis of metastatic lung adenocarcinoma, 296 (27%) NGS panel negative and 276 (26%) KRAS mutant patients were detected. Among these patients, 150 patients whose data were available were 71 (47.3%) NGS panel negative, 54 (36%) KRASother, and 25 (16.7%) KRASG12C. Clinical features, brain metastasis, and first-line chemotherapy response were similar among groups. Bone metastases were detected more often in the NGS panel negative group ( p = 0.03). The median follow-up was 8.4 months. Overall, 107 deaths had occurred at the time of analysis. There was no difference in overall survival ( p = 0.56) or progression-free survival ( p = 0.71) among NGS panel negative, KRASother, and KRASG12C patients. Conclusion: There is no difference in overall survival, first-line chemotherapy response, or progression-free survival among patients with NGS panel negative, KRASG12C, or KRASother metastatic lung adenocarcinoma. Bone metastases were observed more frequently in the NGS panel negative group.

Contrast nephropathy risk has been increasing in cancer patients. Nephrotoxic side effects of anti-vascular endothelial growth factor/receptor (anti-VEGF/R) drugs used in oncologic treatment are also prominent. The purpose of this study was to identify the possible association among anti-VEGF/R drugs use and development of the contrast-induced nephropathy (CIN) in patients with cancers. A total of 92 patients were included in this prospective cross-sectional study. Patients whose glomerular filtration rate (GFR) of

Background To describe the prognostic value of neutrophil–lymphocyte ratio and its effect on survival in in patients with advanced renal cell carcinoma. Methods We retrospectively analyzed 331 patients. The cut-off value of neutrophil–lymphocyte ratio was specified as “3” which is mostly close—and also clinically easily applicable—to the median neutrophil–lymphocyte ratio level of our study group. High group is identified as neutrophil–lymphocyte ratio >3 (n = 160) and low group is identified as neutrophil–lymphocyte ratio ≤3 (n = 163). Results A total of 331 (with 211 male and 120 female) patients were enrolled to study. The median age of the patients was 58. The International Metastatic RCC Database Consortium risk score is calculated for the 72.8% (n = 241) of the study group and among these patients, favorable, intermediate, and poor risk rates were 22, 45.2, and 32.8%. The total usage of tyrosine kinase inhibitors reached 78% of the patients. The median overall survival was 32 months versus 11 months in the neutrophil–lymphocyte ratio low and high groups, respectively (HR: 0.49 (95% CI 0.37–0.65), p Conclusion In conclusion, the pre-treatment value of elevated neutrophil–lymphocyte ratio might be a predictor of poor overall survival in advanced renal cell carcinoma patients.

Aim: The authors present real-world data on the efficacy and safety of nivolumab in patients with metastatic renal cell carcinoma (mRCC). Methods: The Turkish Oncology Group Kidney Cancer Consortium (TKCC) database includes patients with mRCC from 13 cancer centers in Turkey. Patients with mRCC treated with nivolumab in the second line and beyond were extracted from the TKCC database. Results: A total of 173 patients were included. The rates of patients treated with nivolumab in the second, third, fourth and fifth lines were 47.4%, 32.4%, 14.5% and 5.7%, respectively. The median overall survival and progression-free survival were 24.2 months and 9.6 months, respectively. Nivolumab was discontinued owing to adverse events in 11 (6.4%) patients. Conclusion: Nivolumab was effective in patients with mRCC and no new safety signal was observed. WOS:000713725100001 34726480 Q3

Introduction: Ado-trastuzumab emtansine (T-DM1) is an antibody–drug conjugate and its survival advantage has been shown in advanced human epidermal growth factor receptor 2 (HER2)–positive breast cancer. However, clinical trials underrepresent patients ⩾65 years of age, leading to a lack of information in this population. We analyzed the real-world outcomes of older women who were treated with T-DM1 therapy. Methods: We performed a multicenter, observational, retrospective analysis of patients aged ⩾65 years treated with T-DM1. A total of 93 patients from 10 cancer centers were involved in the study. Our goal was to determine the survival, response rates, and toxicity profile in T-DM1–treated patients, as well as the factors that influence survival. Results: Median follow-up was 12.2 months. Objective response rate was 29%. Median progression-free survival (PFS) and overall survival (OS) were 8.47 and 15.0 months, respectively. In multivariate analysis, Eastern Cooperative Oncology Group Performance Score 2 was found to be an independent prognostic factor for worse PFS (hazard ratio [HR] 1.81, p = 0.032) and OS (HR 2.33, p = 0.006). Any adverse event (AE) was seen in 92.5% of patients; grade 3 or 4 AEs were seen in 30.1%. Dose reduction or treatment discontinuation rates were 11.8% and 6.5%, respectively. Conclusion: The efficacy of T-DM1 was acceptable and it was generally well-tolerated among older patients with advanced HER2-positive breast cancer.

We aimed to assess whether anti-EGFR combined chemotherapy regimens are related with loss of skeletal muscle mass and to compare cetuximab and panitumumab therapies in the aspect of skeletal muscle area change as well as to assess whether skeletal muscle mass loss has prognostic significance in the RAS wild mCRC patients. A total of 56 patients (30 patients in cetuximab arm and 26 patients in panitumumab) who had computed tomography images were retrospectively evaluated at the diagnosis and follow up during the treatment period before progression. During treatment period 24 patients (42.8%) had muscle loss. Of these, 7 (29.2%) patients were treated at first-line and 17 (70.8%) patients were treated at second-line setting. There was no significant difference in the aspect of skeletal muscle loss among cetuximab and panitumumab combined treatment regimens. Median PFS was 9.1 (8.6–9.6) months in muscle loss group and 13.9 (7.2–20.6) months in muscle stable group (p = 0.001). Median OS was 23.4 (95% CI 15.8–31.0) months in muscle stable group and 19.1 (95% CI 17.0–21.3) months in muscle loss group (p = 0.57) at first-line setting. For second-line, median OS was 21.2 (14.7–27.7) months in muscle stable group and 14.4 (6.0-22.4) months in muscle loss group (p = 0.003). Decrease in skeletal muscle mass before progression on CT imaging is an independent indicator for shorter PFS value in RAS WT mCRC patients who received anti-EGFR combined chemotherapy regimens at both the first and second-line settings. Beside that shorter overall survival values also were significantly seen in patients who had muscle loss during anti-EGFR therapy in the second-line setting.

Background: We present two cases of secondary pneumothorax after immunotherapy in two different clinics. Case summary: A 25-year old female patient with metastatic osteosarcoma, treated with atezolizumab. Grade 2 pneumonitis developed twice in the first year. Treatment was continued after recovery and areas of pneumonitis and pneumothorax were observed on computed tomography. No other reason could be found to cause pneumothorax. Pneumothorax resorbed spontaneously during follow-up. A 36-year old female patient treated with nivolumab for metastatic renal cell carcinoma (RCC), areas of pneumonitis and pneumothorax were only found as the cause of dyspnea. After treatment, remission was achieved on computed tomography findings. Pneumothorax was detected for the second time during continued therapy, and immunotherapy stopped permanently. Conclusion: These cases, indicate that immunotherapy can cause secondary immune-related pneumothorax based on immune pneumonitis.

Background: Merkel cell carcinoma (MCC) is a rare but highly aggressive neuroendocrine carcinoma of the skin. In this study, we aimed to evaluate the clinicopathologic characteristics, treatment outcomes, and survival of MCC cases in Turkey. Materials and methods: The patients diagnosed with MCC between 1999 and 2018 at twenty different centers in Turkey were included in the study. Patient and tumor characteristics and adjuvant and metastatis treatment outcomes were analyzed retrospectively. Results: The median age of totally 89 patients was 70 (26-93). The most common primary location was lower limbs (n = 29, 32.5%). Immunohistochemically, CK20 positivity was present in 59 patients (66.3%). Only two patients had secondary malignancy. The majority of the patients (n = 76, 85.4%) were diagnosed at the localized stage. Surgery was performed for all patients in the early stage, and adjuvant radiotherapy or/and chemotherapy was applied to 52.6% (n = 40) of nonmetastatic patients. The median follow-up was 29 months. Recurrence developed in 21 (27.6%) of the 76 patients who presented with local or regional disease. Two-year disease-free survival (DFS) was 68.1% and 5-year DFS was 62.0% for localized stage. The 5-year DFS was similar for patients receiving adjuvant treatment (chemotherapy, radiotherapy, or sequential chemoradiotherapy) and without adjuvant therapy (P > 0.05). Two-year overall survival in patients who presented with localized disease was 71.3% and 18.5% in metastatic patients (P < 0.001). In the metastatic stage, platinum/etoposide combination was the most preferred combination regimen. Median progression-free survival (PFS) in first-line chemotherapy was 7 months (95% confidence interval: 3.5-10.5 months; standart error: 1.78). Conclusions: Although MCC is rare in Turkey, the incidence is increasing. Gender, CK20 status, tumor size, lymph node involvement, and adjuvant treatment were not associated with recurrence.

Sinonasal type hemangiopericytoma is a rare soft tissue tumor. Oncogenic osteomalacia (tumor-induced osteomalacia) is a rare syndrome that develops especially due to benign mesenchymal tumors. Nonspecific general bone pain and weakness delay the diagnosis and treatment of oncogenic osteomalacia, and it is difficult to determine the localization of the primary tumor causing oncogenic osteomalacia. A 43-year-old male patient with nasal hemangiopericytoma with symptoms of oncogenic osteomalacia is presented. The patient had musculoskeletal complaints at first and was diagnosed with lumbar disc herniation and surgery was performed. When his complaints recurred 1 year later, he was re-evaluated and diagnosed with hypophosphatemic osteomalacia. Despite the various treatments he received, his complaints did not decrease but increased, so a detailed examination was decided. When the positive PHEX mutation and very high fibroblast growth factor 23 level were detected, PET-CT imaging was performed with a pre-diagnosis of possible oncogenic osteomalacia, but no finding was found. Then he was evaluated with Ga-68 DOTATATE, and the soft tissue mass filling the right ethmoidal sinus was detected. Due to the relation of the mass with surrounding structures, it was considered unsuitable for total excision and incomplete surgical excision was performed. Pathologic evaluation revealed sinonasal type hemangiopericytoma (glomangiopericytoma). A significant remission in the patient's complaints was observed after the operation. Young patients with osteomalacia with unknown causes should be evaluated for malignancy, and screening and further examinations should be performed.

BackgroundSarcopenia is related to poor prognosis and drug toxicities in solid tumors. The aim of our study is to investigate the predisposition of patients with metastatic colorectal carcinoma who started regorafenib treatment to sarcopenia and prolonged survival.MethodsPatients with metastatic colorectal carcinoma who receives regorafenib were search retrospectively. Dose-limiting toxicity was defined as dose reduction or toxicity requiring drug withdrawal. Sarcopenia evaluation was made with computed tomography performed within a month before treatment. Progression-free survival and overall survival were estimated.ResultsThirty-six patients were found as suitable for the study. 63.9% of patients were found as basally sarcopenic. Dose-limiting toxicity occured 13 of 23 patients (56.5%) with basal sarcopenia, whereas only 1 of 13 patients (7.6%) with no sarcopenia exhibited dose-limiting toxicity (p=0.005). Three patients suffered from grade 3-4 toxicity. Hand-foot syndrome, hypertension, and mucosal rash were the most seen side effects. Mean regorafenib treatment duration was 3.36 months. There was no significant difference in the progression-free survival (PFS) and the overall survival (OS) between sarcopenic patients and patients with no sarcopenia. Durations were as OS 24.2 weeks in patients with sarcopenia (95% CI 16.7-31.7), 28.1 weeks in patients with no sarcopenia (95% CI 20.5-35.7) (p=0.36), and as PFS 14.2 weeks in patients with sarcopenia (95% CI 12.1-16.4), 14.8 weeks in patients with no sarcopenia (95% CI 9.7-20.1) (p=0.65).ConclusionDose-limiting toxicity was significantly higher in basally sarcopenic patients who were started regorafenib as treatment of metastatic colorectal carcinoma. There was no significant relationship between overall survival and progression-free survival with sarcopenia.

Amac: Kolorektal kanser en sik gorulen kanserlerden biridir ve hastalik surecinde karaciger metastazi sik olarak gelismektedir. Albumin-bilirubin (ALBI) skoru/gradinin hepatoseluler kanserde sagkalimi predikte ettigi gosterilmistir. Bu calismada ALBI skoru/gradinin karaciger metastatik kolon kanserindeki prognostik degerinin arastirilmasi amaclanmistir. Yontemler: Kolorektal kanser tanili ve senkron ya da metakron karaciger metastazi olan hastalarin tibbi kayitlari incelenmistir. Karaciger metastazinin saptandigi andaki serum albumin, total bilirubin, laktat dehidrojenaz, karsinoembryonik antijen and notrofil-lenfosit orani belirlenmistir. Albumin ve bilirubin kullanilarak ALBI skoru hesaplanmis ve derecelendirilmistir. Prognostik faktorler cok degiskenli regresyon modelleri ile degerlendirilmistir. Bulgular: Calismaya 223 hasta dahil edildi. Medyan genel sagkalim ALBI grad 1, 2 ve 3 icin sirasiyla 23.9, 16.0 ve 4.0 ay olarak saptandi (P

Introduction and aim To investigate the effect of the prognostic nutritional index on treatment response and survival in patients with metastatic renal cell cancer. Methods We retrospectively analyzed the treatment modalities; the demographic, clinical and pathological features of 396 patients with RCC and prognostic nutritional index. Based on the median value, patients were grouped as having low and high prognostic nutritional index values. Kaplan-Meier method was used for survival analysis, and Cox-regression analysis was used for multivariate analysis. Results The median overall survival was 39 months (95% CI 26.1–51.8), 28 months (95% CI 17.9–38) and 7 months (95% CI 4.7–9.2) in patients with favorable, intermediate and poor International Metastatic Renal Cell Carcinoma Database Consortium risk group, respectively. The difference between the groups was statistically significant (p 38.5) group (p Conclusion In patients with renal cell cancer, prognostic nutritional index is closely related to survival and has prognostic significance.

321 Background: Immune checkpoint inhibitors (ICIs) started a new era in the treatment of metastatic renal cell carcinoma (mRCC). CheckMate-025 and CheckMate-214 trials established the effect of ICIs in the second-line and upfront therapy of mRCC, respectively. This study aimed to share a real-life experience regarding nivolumab in the second-line treatment and beyond in mRCC Methods: We retrospectively searched the Turkish Oncology Group Kidney Cancer Consortium (TKCC) database, which is the multicenter registry system, and extracted patients treated with nivolumab in the second line and beyond. The patients treated with nivolumab plus targeted therapy or ipilimumab were excluded. The primary endpoint was overall survival (OS). The secondary endpoints were response rates and safety. Results: A total of 134 patients were included in this study. The median age at the starting of nivolumab treatment was 61 years (Inter Quartile Range (IQR):55-67). Three out of four patients were male. One hundred four patients (78%) had previous nephrectomy. The majority of patients had clear-cell pathology (83%). Thirteen patients (10%) had sarcomatoid features. According to International Metastatic RCC Database Consortium (IMDC) risk score, seventy patients (52%) were in the intermediate and poor prognostic group. The previous drugs administered in each line before nivolumab are shown in the table below. The number of patients treated with nivolumab was 63(47%), 45(33%), 17(13%), and 9(7%) in the second-, third-, fourth-, and fifth-line setting, respectively. The median OS was 34 months (95% Confidence Interval (CI): 24.1-43.8)) with the 15 months (IQR:5-26) median follow-up. Objective response rate (ORR) and disease control rate (DCR) was 33% and 57%, respectively. The most common grade 3 or higher AEs leading to treatment discontinuation were pneumonitis (%1.4) and colitis (

Introduction Colovesical fistulas are one of the most frequent complications in fistulizing Crohn's disease. Fistulizing Crohn's disease and tumor coexistence may lead to tumor spread through the fistula. Case report In this study, a 62-year-old male patient with colon cancer spreading to bladder mucosa through the colovesical fistula due to Crohn's disease is presented. He was treated and followed up for Crohn's disease and in the routine follow-up colonoscopy, a mass was observed in sigmoid colon. Computed tomography demonstrated the mass as a local disease. The patient underwent both left hemicolectomy and due to intraoperative colovesical fistula, subsequently, fistulectomy. Pathologic evaluation revealed stage 1 adenocarcinoma of the colon. Transurethral resection was performed for postoperative evaluation and a mass was detected and resected in the bladder. Pathologic findings of resected specimens were consistent with metastasis of adenocarcinoma of the colon. The clinical features, diagnosis and treatment data were analyzed retrospectively and it was thought that the existing tumor spreads to the bladder through the colovesical fistula due to no invasion into the muscularis propria layer of the bladder. Management and outcome Since muscle invasion was not detected in the bladder after TUR-T, cystectomy was not planned. 8 cycles of systemic adjuvant chemotherapy (Oxaliplatin and Capecitabine) were planned for 6 months. Gastroenterology consultation was requested for Crohn's disease treatment. It was recommended to discontinue azathioprine and continue with adalimumab therapy. Discussion Colovesical fistula may develop in Crohn's disease that is not in remission and the fistulae can lead the metastasis of tumors.

Calciphylaxis, also known as calcific uremic arteriolopathy (CUA), is usually observed in women and it is a serious complication of hyperparathyroidism secondary to chronic renal failure. CUA is characterized by ischemic tissue loss secondary to progressive vascular degeneration. Although it is rare, it may end up with sepsis and organ failure and can be fatal. Its pathogenesis is not fully understood, but it is thought that it occurs secondary to increased calcification activators such as oxidized LDL, TNF- α, calcitriol, fibronectin, collagen-I, and TGF-1α. The most effective treatment is managing underlying pathology and decreasing serum calcium and phosphorus levels. In this report, we aimed to present an end stage renal failure case with coexisting hyperparathyroidism, hyperthyroidism and calciphylaxis in whom cutaneous manifestations were healed 6 months after parathyroidectomy.

Objective. This study aimed to evaluate concurrently detected second primary malignancy in the patients who underwent surgery for papillary thyroid carcinoma. Methods. In this study, we retrospectively analyzed the files of the patients who underwent surgery for papillary thyroid carcinoma between 2000-2017. A total number of 601 patients with papillary thyroid carcinoma were evaluated. Among these patients, 48 patients were found to have secondary primary tumors. Preoperative and postoperative laboratory examination findings of the patients were retrospectively recorded. Results. Among 601 patients with papillary thyroid cancer evaluated with respect to radiation exposure, the second primary tumor with breast cancer was found to be the most common tumor. Renal cell carcinoma, malignant melanoma and stomach cancer were found to be more frequent when evaluated regardless of radiation effect. Furthermore, when molecular genetic results were evaluated, BRAF mutation rate was found to be more frequent than in other secondary tumors, especially in patients with renal cell carcinoma. Conclusions. The importance of epidemiological and experimental studies of multiple cancers is obvious. Although it is known that the impact of radiation is considerable among the ones with concurrence of breast cancer and papillary thyroid carcinoma, we suggest that further studies on common molecular genetic characteristics and development of targeted treatment for detected molecules are required in the patients with renal cell carcinoma in whom papillary thyroid carcinoma is diagnosed regardless of radiation effect.

Renal cell carcinoma is a common malignancy of uroepithelial region. It may metastasize even years after nephrectomy. Metastatic disease of thyroid gland is rare, the most common one is being renal cell carcinoma. Unlike the cases reported in the literature as tumor to tumor metastasis, our case had co-occurrence of multifocal renal cell carcinoma metastasis in the left thyroid lobe and thyroid papillary carcinoma in the right thyroid lobe, which were diagnosed at the same time. We presented this case due to its rare occurrence.

Introduction: This study aimed to evaluate concurrently detected thyroid pathologies in the patients who underwent surgery for primary hyperparathyroidism (PHPT). Materials and Methods: In this study, we retrospectively analyzed the files of the patients who underwent surgery for PHPT between 2012 and 2015. Pre- and post-operative laboratory examination results and preoperative radiological and nuclear medicine findings of the patients were retrospectively recorded. Results: A total number of 41 patients with PHPT were divided into two groups as the Group 1 with PHPT and benign thyroid pathology (21 patients) and the Group 2 with PHPT and malignant thyroid pathology (20 patients). In Group 1, 18 and 3 of 21 patients were females and males, respectively. Group 2 included 15 male and 5 female patients. The mean age of the patients was found to be 55.6 and 53.9 years in Group 1 and Group 2, respectively. Both groups were matched for age and gender. In terms of thyroid pathology, 20 of 41 patients (48.7%) who underwent total thyroidectomy for PHPT were found to have thyroid papillary carcinoma while benign pathologic conditions were detected in 21 (51.3%) individuals. Conclusions: Cooccurrence of thyroid diseases and PHPT is common. Therefore, all the patients should preoperatively be evaluated for the presence of thyroid pathology to determine the technique of parathyroid surgery.

Glucocorticoids are used for the treatment of many diseases, such as inflammatory, allergic, autoimmune, and neoplastic diseases. They can be used in the form of topical, oral, inhalable, rectal, and intra-articular agents. Many topical steroid-related iatrogenic Cushing′s syndrome cases affecting especially children have been reported in the literature. Topical steroid-related Cushing′s syndrome is rarely seen in adults. In this report, we present the case of a 32-year-old male patient with iatrogenic Cushing′s syndrome related to long-term clobetasol propionate treatment for psoriasis. In the context of such treatment, the glucocorticoid withdrawal problem has to be overcome. At present there is no consensus on steroid withdrawal. Patients on long-term glucocorticoid treatment must be evaluated for potential adverse effects and withdrawal symptoms by their physician and their endocrinologist.