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Öğe Assessment of Quality of Life Following Radiotherapy in Patients with Rectum Cancer(Springer, 2022) Yavuz, Berrin Benli; Aktan, Meryem; Kanyilmaz, Gul; Demir, Lutfi SaltukPurpose The aim of the present study is to investigate the effects of radiotherapy (RT) on quality of life (QoL) and influencing factors. Methods Data of 106 patients who completely filled out the three questionnaires were evaluated in this prospective study. Quality of life was evaluated with cancer-specific QLQ-C30 and colorectal cancer module QLQ-CR29 created by European Organization for Research and Treatment of Cancer (EORTC). All statistical analyses were done with SPSS version 22 software. A p level of < 0.05 was accepted as statistically significant. Results Median age was 61 (27-86). Of the patients, 77 (72.6%) were male and 29 (27.4%) were female. When QLQ-C30 questionnaires were evaluated, it was observed that physical, role, cognitive, and emotional function scores were impaired following RT, however returned to pre-RT levels on control. According to the results of QLQ-CR29 questionnaire, after RT, impairment was observed in urination frequency, urinary incontinence, stool frequency, dysuria, fecal incontinence, embarrassment, and sexual interest in male scales; however, they returned to pre-RT values on control. When evaluated with regard to age, financial difficulty, global health score, mucus in stool, dysuria, dyspareunia, and abdominal pain were observed to be poorer in the young; urination frequency and urinary incontinence were observed to be poorer in the elderly. Conclusion Although both functional and symptom scales were shown to impair, most of them were detected to be temporal and patients could well tolerate radiotherapy. Additional assessment is required for evaluating the late effects of treatments on QoL.Öğe Brain metastases from prostate cancer: A single-center experience(Aves, 2019) Kanyilmaz, Gul; Aktan, Meryem; Yavuz, Berrin Benli; Koc, MehmetObjective: Metastases from prostate cancer to the brain are very unusual and very few case series have been reported in the literature. Present study was performed to assess the proportion of brain metastasis from prostate cancer among other brain metastasis in men, to evaluate the distribution, pattern and magnetic resonance imaging (MRI) appearance of these metastatic lesions, and prognosis of brain metastasis in patients with prostate cancer. Material and methods: Between January 2010 and November 2016, 339 males who had received radiotherapy at our department were retrospectively reviewed. After the first evaluation of patients data, we reviewed only the patients with brain metastases from prostate cancer. We evaluated MRI characteristics of metastatic brain lesions and characteristics of the patients, tumor and treatment modalities. Results: Ten of 339 patients (2.9%) had brain metastases from prostate cancer. Sixty percent of the patients had pure intraparenchymal metastasis, 20% of the patients had pure extensive dural metastasis and 20% of them had both. Seventy-five percent of the patients with intraparenchymal metastasis had multiple metastatic lesions. The median prostate specific antigen (PSA) level was 49.40 ng/mL and the Gleason score was >= 7 in all patients. Sixty percent of the patients had distant metastasis at the time of the diagnosis of prostate cancer. Median survival time in patients with brain metastasis was 4.5 months. Conclusion: Lesions of brain metastasis from prostate cancer had a large variety of imaging presentation and it is very difficult to distinguish them from the other brain metastasis originating from other types of cancer. Presence of a disseminated disease, high PSA level and high Gleason score can be useful parameters for the prediction of brain metastasis from prostate cancer.Öğe Breast Cancer Among Patients Below Age 40: Clinicopathological Features and Survival Results(Akad Doktorlar Yayinevi, 2020) Yavuz, Berrin Benli; Aktan, Meryem; Kanyilmaz, GulAmong young women breast cancer exhibits quite a heterogenous, quite agressive and complex biology. The purpose of this study is to describe clinicopathological features that affect survival ratio among breast cancer women below age-40. 803 patients having received adjuvant radiotherapy were retrospectively analyzed. Patients were categorized under two groups: age <= 40 and age > 40. Treatments and clinicopathological features were analyzed. 19.4% (156) of 803 patients were below age 40. In patient group below age 40, more neoadjuvant chemotherapy (NAC) was administered compared to the patient group above age 40 (p= 0.007) and it was detected that there were higher incidences of stage 3 disease (p= 0.011), more advanced nodal disease (N2-3) (p= 0.046) and more metastasis (p< 0.001). In conducted multivariate analysis for all age groups presence of N2-3 disease (p= 0.011) and in below age-40 group being grad 3 (p= 0.025) was found to affect overall survival (OS) negatively. In disease free survival (DFS)-focused analysis; for all age groups, receiving NAC (p= 0.001), presence of N2-3 disease (p= 0.002) and being below age 40 were found to have a negative effect; in below age-40 group presence of NAC (p= 0.013) and perineural invasion (p= 0.035); in above age-40 group receiving NAC (p= 0.023) and presence of N2-3 disease (p= 0.035) had a negative effect. Being below age 40 is an independent prognostic factor for DFS. It is suggested to conduct further studies on specific tumor biology to analyze the same group with respect to the characteristics of more aggressive tumors.Öğe Comparison of Prognostic Factors in Glioblastoma Patients with Short- and Long-term Survival(Kare Publ, 2023) Yavuz, Berrin Benli; Kanyilmaz, Gul; Aktan, MeryemOBJECTIVE Glioblastoma (GBM) is the most aggressive primary brain tumor. Despite all treatments, very few have long-term survival. This retrospective study aimed to investigate the clinicopathological features, treatment modalities, and factors affecting survival in GBM patients with short-and long-term survival. METHODS Data from 217 GBM patients who received radiotherapy (RT) between 2010 and 2021 were analyzed. The patients were divided into two groups: short (<6 months) and long (>2 years) living groups. Treatment, patient, and tumor characteristics were evaluated. RESULTS While 37 (17.1%) of 217 patients included in the group lived <6 months, 49 (22.6%) were in the group that lived longer than 2 years. In the long-living group, being under 65 years of age, having better performance, performing total excision, applying conventional RT, and receiving adjuvant chemotherapy (CT) detected more frequently. The regression test showed that young age, good performance, and receiving conventional RT and adjuvant chemotherapy (CT) were independently associated with survival. CONCLUSION It was observed that patients who lived longer were frequently young and well-performing ones who underwent wide excision and received conventional RT and adjuvant CT. By estimating the pre-treatment survival, treatment and support plans can be made accordingly.Öğe The dosimetric comparison and evaluation of helical tomotherapy, volumetric-modulated arc radiotherapy (VMAT), step-and-shoot and sliding window radiotherapy techniques in nasopharyngeal carcinoma(Pergamon-Elsevier Science Ltd, 2022) Demir, Hikmettin; Aras, Serhat; Buyukcizmeci, Nihal; Yavuz, Berrin BenliThe aim of this study was to dosimetrically compare treatment plans prepared with volumetric-modulated arc radiotherapy (VMAT), tomotherapy, step-and-shoot and sliding radiotherapy techniques in nasopharyngeal cancer (NPC) and to evaluate the superiority of different techniques in routine clinical practice. Treatment plans obtained by VMAT, tomotherapy, step and shoot and sliding window techniques were evaluated for twenty NPC patients. Different treatment plans were prepared by using the simultaneous integrated boost (SIB) technique in 35 fractions of 70Gy to primary planning target volume and 56Gy to elective lymph nodes. While NPC treatment plans were obtained in four different radiotherapy techniques, 95% of the target volumes were provided with defined dose coverage and critical organs received the lowest possible dose. In addition to the doses received by target tissues and critical organs, dose delivered time, monitor unit (MU), dose homogeneity (HI) and conformity (CI) index were compared for different radiotherapy techniques. The D-95 dose coverage and lowest maximum dose values (Dmax) are better achieved in the tomotherapy technique for primary tumor and elective lymph node target volumes. However, the lowest dose coverage is obtained in the step-and-shoot technique (p < 0.05). Although the highest MU value was calculated in tomo-therapy, the lowest delivered time was also achieved in the VMAT technique. It was observed that different radiotherapy techniques had advantages and disadvantages compared to each other at certain dose-volume constraints (D-max, D-min, D-mean,D- D-1, and V-30) for organs at risk. Although the tomotherapy technique was better in target volume dose coverage, it was observed that other techniques had superiority over each other in terms of protection of organs at risk and dosimetric parameters for NPC patients.Öğe Factors affecting pathological response and survival following neoadjuvant chemoradiotherapy in rectal cancer patients(Wolters Kluwer Medknow Publications, 2021) Aktan, Meryem; Yavuz, Berrin Benli; Kanyilmaz, Gul; Oltulu, PembeBackground: Despite all advanced treatment methods for rectal cancer, not all patients can provide an adequate response, and hence, possible prognostic factors must be evaluated. The aim of this study was to evaluate the relationship between systemic inflammatory markers and pathological response, overall survival (OS) and disease-free survival (DFS) in patients treated with neoadjuvant chemoradiotherapy (nCRT). Methods: We evaluated data of 117 patients for the period 2010 to 2017. Serum measurements of albumin, hemoglobin, C-reactive protein, modified Glasgow prognostic score (mGPS), and white cell counts were obtained. Rodel scoring system was used to determine pathologic tumor regression. Results: Overall, 77% of the patients were in the good response group according to the radiological images. A total of 48% of patients were categorized as a good pathologic response. Pathologic response to treatment was associated with a mGPS of 0 (P = 0.001), normal platelet lymphocyte ratio (PLR) (P = 0.003), TNM stage (P = 0.03), pathologic T stage (P = 0.001), radiologic response to nCRT (P = 0.04), tumor differentiation (P = 0.001), lymphovascular invasion (LVI) (P = 0.001) and perineural invasion (P = 0.02). LVI (P = 0.04), albumin level (P = 0.05), C-reactive protein (P = 0.01), neutrophil platelet score (NPS) (P = <0.001) and mGPS (P = 0.01) had a statistically significant effect on OS. Operation type (P = 0.03), tumor differentiation (P = 0.01), depth of invasion (P = 0.03), NPS (P < 0.01), mGPS (P = 0.01), PLR (P = 0.004), neutrophil-lymphocyte ratio (P = 0.01) and LVI (P = 0.05) were statistically significant on DFS. Conclusions: There was an association between systemic inflammatory markers and pathologic response and also, between OS and DFS. This study can be preliminary data for prospective controlled studies.Öğe The Influence of Hormone Therapy on the Development of Pulmonary Fibrosis after Radiotherapy in Patients with Breast Cancer(Akad Doktorlar Yayinevi, 2022) Yavuz, Berrin Benli; Poyraz, Necdet; Kanyilmaz, Gul; Aktan, Meryem; Tuncez, Ismail H.; Koc, MehmetThe aim of the present study is to investigate the effects of hormone therapy on pulmonary fibrosis in patients who received curative conformal radiotherapy for breast cancer. Data of 469 patients were evaluated. Computerized tomography images were evaluated by a radiologist as blindly. The influence of hormone therapy (tamoxifen and aromatase inhibitors), age, menopause, radiotherapy fields, ipsilateral lung volume receiving 5 Gy (V5), ipsilateral lung volume receiving 20 Gy (V20), ipsilateral mean lung dose (MLD) and the effects of taxane group of chemotherapy on pulmonary fibrosis were investigated. The mean age was 51 (range 27-83) years. As hormone therapy, 159 patients (33.9%) used tamoxifen and 253 patients (53.9%) used aromatase inhibitors. A significant relationship was found between both 6th month lung fibrosis and 2nd year lung fibrosis, and V5, V20, MLD, regional lymphatic irradiation and hormone therapy use. More grade 2 fibrosis was detected in the patients who received tamoxifen compared to the patients who received aromatase inhibitors and the control group (p< 0.001). No association was found between menopausal status, age, and taxane group chemotherapy and lung fibrosis development. In multivariate analysis, V5, MLD, and using hormone therapy were shown to be independent predictors of the risk of developing fibrosis at both 6 months and 2 years. Use of tamoxifen increases early and late lung fibrosis more than aromatase inhibitors in patients who receive radiotherapy for breast cancer. However, V5, V20, MLD and regional lymph node irradiation also contribute to the prevalence of fibrosis.Öğe Intramedullary spinal cord metastasis and radiotherapy(2018) Yavuz, Berrin Benli; Aktan, Meryem; Kanyılmaz, GülAim: Intramedullary spinal cord metastasis (ISCM) is a rare but a severe condition. We aimed to evaluate the clinical features, the effect of radiotherapy on the functional results, and the quality of life and survival in patients with ISCM.Material andMethods: We retrospectively assessed the results of 15 patients. Patients underwent 3D conformal radiotherapy (3D-CRT). Patients were reviewed in terms of neurological deficits, the localization of primary tumors, the duration of symptoms, onset symptoms, the localization of ISCM, and the interval between diagnosis and spinal metastasis. Post-radiotherapy outcomes and factors influencing the survival and the quality of life were analyzed. Results: The mean duration of symptoms before diagnosis was 14.93 days (range; 1-52 days). The most common presenting symptoms of patients were lower back and back pain. Neurological deficit was present in 9 patients. Of these patients, partial improvement was observed following the radiotherapy in four patients. After the radiotherapy, the need of painkillers and pain were decreased in 10 of the patients with pain at the outset (66.7%). An association was detected between the initiation of radiotherapy within 10 days from the onset of symptoms and the quality of life (p=0.026). The mean survival rate was 5.9 months after being diagnosed with ISCM.Conclusions: Motor deficit and pain-related quality of life were corrupted in most of the patients with ISCM. Early diagnosis and suitable treatment might promote to the functional condition of the patient. It is important to initiate radiotherapy within a period of less than 10 days from the onset of symptoms.Öğe Prognostic importance of expression of mini-chromosome maintenance proteins (MCMs) in patients with nasopharyngeal cancer treated with curative radiotherapy(Assoc Brasileira Otorrinolaringologia & Cirurgia Cervicofacial, 2022) Kanyilmaz, Gul; Oltulu, Pembe; Yavuz, Berrin Benli; Aktan, MeryemObjective: The prognostic importance of minichromosome maintenance complex expression in nasopharyngeal cancer is still unknown. We aimed to find whether minichromosome maintenance complex 2-7 expression may potentially be used to predict the prognosis of nasopharyngeal cancer patients treated with definitive radiotherapy. Methods: Between April 2007 and July 2020, patients with nasopharyngeal cancer treated with radiotherapy were identified. Immunohistochemical analysis was performed on formalin-fixed paraffin-embedded tissues of cases. A single pathologist analyzed the histologic specimens of all patients. Results: Totally, 67 patients were included. The median followup was 75.3 months. Higher tumor (T) stage was correlated with minichromosome maintenance complex 2 overexpression. Minichromosome maintenance complex s expression was also associated with histopathologic subgroups. According to univariate analysis, AJCC stage, histopathological subgroups, tumor response after treatment, minichromosome maintenance complex 2, 3, 5, 6 and 7 expression were the prognostic factors that predict overall survival. According to multivariate analysis minichromosome maintenance complex 7 expression was the only prognostic marker for bothprogression-free survival and overall survival. Conclusion: The overexpression of minichromosome maintenance complex 2, 3, 5, 6 and 7 indicated bad prognosis. Minichromosome maintenance complex 7 was an independent prognostic factor for survival outcomes in nasopharyngeal cancer and may be a potential therapeutic target for treatment. (c) 2021 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).Öğe Prognostic Importance of Ki-67 in Breast Cancer and Its Relationship with Other Prognostic Factors(Aves, 2019) Kanyilmaz, Gul; Yavuz, Berrin Benli; Aktan, Meryem; Karaagac, Mustafa; Uyar, Mehmet; Findik, SiddikaObjective: The clinical feature of breast cancer is very heterogeneous because of the variable prognostic factors impact its behaviour. The aim of study is to find the prognostic importance of Ki-67 and to analyse the correlation between Ki-67 index and the other conventional prognostic factors in breast cancer patients. Materials and Methods: Between 2010 and 2017, patients with invasive ductal carcinoma who received radiotherapy after surgery were included in study. A single pathologist re-defined of all cases retrospectively. Ki-67 were established three categories based on Ki-67 levels: low (<10%), intermediate (10-25%) and high (>25%). Results: A total of 258 patients were included. 46 of 258 (18%) patients were in low, 82 of 258 (32%) patients were in intermediate and 130 of 258 (50%) patients were in high Ki-67 group. There were no correlations between menopausal status, age, and Ki-67 level. Low-pT stages tended to have low Ki-67 expression (p=0.07). Low-pN stages correlated with low Ki-67 values (p=0.007). Patients with ECE (+) were prone to have higher Ki-67 values (p=0.02). The significant correlation was seen between Ki-67 and tumour grading (p=<0.0001). Patients with LVI (+) had higher Ki-67 expression (p=0.007). Luminal A tumours were correlated with low Ki-67 group (p=<0.0001). Ki-67 values had significant effect on DFS (p=0.03) but not OS (p=0.09). Conclusion: This study showed that high Ki-67 expression is associated with higher pT-stage, higher pN-stage, higher grade, ER/PR negativity, HER2/neu positivity, ECE and LVI positivity. The prognostic impact of Ki-67 was only demonstrated for DFS.Öğe Prognostic Value of IDH-1, PTEN and EGFR Expression in High Grade Gliomas(Akad Doktorlar Yayinevi, 2019) Aktan, Meryem; Findik, Sidika; Kanyilmaz, Gul; Yavuz, Berrin Benli; Koc, MehmetGliomas are the most common primary brain tumors in adults. Despite advances in modem diagnostic procedures and therapies, the prognosis is still poor. To improve survival and the knowledge about the biological and clinical presentation of gliomas, more individualised and targeted treatments are needed. The aim of this study was to correlate the immunostaining patterns of isocitrate dehydrogenase-1 (IDH-1), phosphatase and tensin homolog (PTEN) and epidermal growth factor (EGFR) with progression-free survival (PFS) and overall survival (OS) in high grade gliomas patients. We analized 60 high grade gliomas who underwent surgery and standard chemoradiotherapy. Immunohistochemical methods were used to classify the IDH-1 gene mutation presence, staining patterns of PTEN and EGFR in tumor samples of the diagnosis. Median follow-up time was 18.9 months. There was significant relation between IDH-1 mutation and OS. Median OS was 37.9 months for patients with IDH-1 mutation, 12.4 months for patients with no mutation (p< 0.001). Median PFS was 29.8 months for patients with no IDH-1 mutation and 70.4 months for patients with IDH-1 mutation (p= 0.03). There was no significant relation between PTEN and EGFR immunopattern and OS or PFS in univariate analysis. However, there was significant relation between immunoreactivity of PTEN and OS (p= 0.03), immunointensity of PTEN and OS (p= 0.02) in multivariate analysis. In conclusion, the relationship between EGFR mutation and OS and PFS can also be demonstrated by studies with more patients.Öğe Prognostic value of pre-treatment 18F-FDG-PET uptake in small-cell lung cancer(Springer, 2017) Aktan, Meryem; Koc, Mehmet; Kanyilmaz, Gul; Yavuz, Berrin BenliPurpose Small-cell lung cancer (SCLC) is an aggressive disease, despite an initially favorable response to treatment, and its prognosis is still poor. Multiple parameters have been studied as possible prognostic factors, but none of them are reliable enough to change the treatment approach. F-18-fluorodeoxyglucose-positron emission tomography (FDG-PET) is a novel imaging technique for staging of SCLC. The aim of this study was to evaluate the prognostic value of pre-treatment FDG-PET parameters on clinical outcome in limited stage (LS) SCLC patients treated with curative thoracic radiotherapy (RT) and chemotherapy. Clinical records of 46 LS-SCLC patients with pre-treatment FDG-PET imaging were retrospectively reviewed. Patients were treated with definitive RT for a total dose of 50-60 Gy and chemotherapy. The clinical endpoints were progression-free survival (PFS) and overall survival (OS). The median age was 59 (range 30-82) years, and median follow-up time was 23.2 months (range 5-82.8 months). Median OS was 30.9 months for pre-treatment tumor maximum standardized uptake value (SUVmax) < 9.3 and 20.6 months for SUVmax ae9.3 (p = 0.027) and PFS was 55.6 months for SUVmax < 9.3 and 38.6 months for SUVmax ae9.3 (p = 0.16). Median OS was 73 months for pre-treatment lymph node SUVmax < 5.8 and 21 months for ae5.8 (p = 0.01) and PFS was 38.6 months (range 6.8-70.3 months) for SUVmax-LN ae5.8; all patients with SUVmax-LN < 5.8 were alive (p = 0.07). Median survival time was 28.2 months (range 21.7-34.7 months) for patients younger than 65 and 8.7 months (range 5.7-11.8 months) for those ae65 years (p = 0.00). Pre-treatment FDG-PET uptake may be a valuable tool to evaluate prognosis in SCLC patients. Patients with a higher pre-treatment FDG uptake may be considered at increased risk of failure and may benefit from more aggressive treatment approaches.Öğe Pyruvate kinase M2 (PKM-2) expression and prognostic significance in glioblastoma patients(Springer, 2023) Yavuz, Berrin Benli; Kilinc, Fahriye; Kanyilmaz, Gul; Aktan, MeryemPurposePyruvate kinase M2 (PKM2) is a key enzyme that catalyzes the irreversible and final step of glycolysis. It is closely associated with cancer development and progression. The relationship between PKM2 and prognosis in glioblastoma (GB) patients is unknown. The aim of this study was to measure PKM2 expression and evaluate its effect on prognosis in GB patients.MethodsPatients who underwent radiotherapy (RT) for glioblastoma between 2010 and 2021 were evaluated immunohistochemically. A single pathologist evaluated pathology specimens of all patients. The intensity and extent of staining of tumor cells were scored. Patients were categorized as low and high PKM2.ResultsA total of 119 patients were evaluated. While 80.7% of the cases had a low score, 19.3% had a high PKM2 score. It was observed that the group with high PKM2 expression had lower performance, received more hypofractionated RT and received adjuvant chemotherapy (CT) less frequently. Median overall survival (OS) was 15.77 months in the low PKM2 expression group and 6.50 months in the high PKM2 group. In univariate analyses, PKM2 expression, age, performance status, type of surgery, RT scheme, and concurrent and adjuvant CT were prognostic factors in predicting OS. In multivariate analyses, PKM2 expression, type of surgery, RT scheme and receiving adjuvant CT were prognostic factors for OS.ConclusionPKM2 is an independent prognostic factor for survival and is associated with poor prognosis in GBM patients treated with radiotherapy. It may be a potential therapeutic target for anticancer therapy.Öğe The Significance of Extent of Extracapsular Extension in Patients with T1-2 and N1 Breast Cancer(2018) Kanyılmaz, Gül; Fındık, Sıddıka; Yavuz, Berrin Benli; Aktan, MeryemObjective: The prognostic importance of extracapsular extension (ECE) in breast cancer is not yet clear, especially in patients with pathologicalT1-2 and N1 (pT1-2N1) disease. We aimed to investigate whether the extent of ECE was an independent prognostic factor for survival outcomesin patients with pT1-2N1 breast cancer.Materials and Methods: A total number of 131 patients with pT1-2N1 breast cancer treated between 2009 and 2015 were retrospectively evaluated. A single pathologist re-analyzed the histologic examples of all cases. The extent of ECE was graded from 0 to 4.Results: There was a significant correlation between the number of lymph nodes involved and ECE grade (p0.004). According to the univariateanalysis, lymphovascular invasion (LVI) and ECE grade were the significant prognostic factors for overall survival (OS); age, number of metastaticlymph nodes, menopausal status, and ECE grade were the prognostic factors for disease-free survival (DFS). With a median follow-up of 46 months,grade 3-4 ECE seems to be notably associated with a shorter OS and DFS in multivariate analysis. The mean OS was 85 months for the patients withgrade 0-2 ECE vs 75 months for the patients with grade 3-4 ECE (p0.003). The mean DFS was 83 months for the patients with grade 0-3 ECE vs68 months for the patients with grade 4 ECE (p0.0001).Conclusion: This research has shown that the extent of ECE is an important prognostic factor for survival in pT1-2N1 breast cancer patients andgrade 3-4 ECE seems to be notably associated with a shorter OS and DFS.Öğe Two cases of gastrointestinal stromal tumor of the small intestine with liver and bone metastasis(Ame Publ Co, 2015) Aktan, Meryem; Koc, Mehmet; Yavuz, Berrin Benli; Kanyilmaz, GulGastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. These tumors most commonly occur in the stomach (60%), jejunum and ileum (30%). Metastasis is characteristically the malignant behavior of the GISTs. GISTs most frequently metastasize to the liver and peritoneum, whereas bone and lung metastases are uncommon sites. Here, we described two cases of bone and liver metastases in patients with advanced GISTs. Both of them showed liver metastasis at disease presentation and bone metastasis in early time after the diagnosis. Bone metastases involved the lumber spine and right femur in first patient and L2 vertebral body in the second case. All of the lesions presented a lytic pattern. These cases are presented because of the rare incidence of bone metastasis to femur and vertebral bodies. More attention should be paid to the diagnosis of bone metastases from GISTs in clinical practice despite the shortage of available data on the sensitivity and specificity of bone scintigraphy and PET-CT.
