Browsing by Author "Esmez, Omer"

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Chromophobe Renal Cell Carcinoma with Metastatic Progression and Cabozantinib-Induced Hand-Foot Syndrome
(BMJ Publishing Group, 2025) Esmez, Omer; Esmez, Merve Yildiz; Deniz, Gulnihal
Renal cell carcinoma (RCC) comprises a heterogeneous group of neoplasms with variable prognoses. Chromophobe RCC, a relatively uncommon subtype, generally follows an indolent clinical course but may occasionally exhibit aggressive or metastatic behaviour. This report describes a woman in the mid 60s with a history of partial nephrectomy for chromophobe RCC who subsequently developed metastatic disease. Systemic treatment with cabozantinib was initiated, resulting in dermatological toxicity. Serial imaging over 4 years demonstrated progressive metastatic involvement, including hepatic lesions. This account underscores the challenges of managing metastatic chromophobe RCC, differentiating true recurrence from potential second primary malignancies and addressing the adverse effects of targeted therapies such as cabozantinib.
Clubbing of Ipsilateral Fingers Following Ganglion Cyst Surgery: A Case Report
(Wiley, 2024) Esmez, Omer; Deniz, Gulnihal; Key, Sefa
Does Arthroscopic Rotator Cuff Repair Improve Kinesiophobia, Depression, and Spatiotemporal Parameters in the Long Term
(Erciyes University School of Medicine, 2023) Deniz, Gulnihal; Bilek, Furkan; Esmez, Omer; Gulkesen, Arif; Gurger, Murat
Objective: This study aimed to investigate the long-term effects on pain, kinesiophobia, depression, functional capacity, balance, mobility, and spatiotemporal parameters in individuals who underwent rotator cuff (RC) surgery.Materials and Methods: Measurements were conducted on 45 individuals recommended for RC arthroscopy. These included bilateral upper extremity range of motion (ROM), muscle strength, bilateral hand grip strength, spatiotemporal parameters, 9-hole peg test (9-HPT), Beck Depression Inventory (BDI), Tampa Scale of Kinesiophobia (Tampa), Shoulder Pain and Disability Index (SPADI), and Constant-Murley Score. All measurements were taken one week before and six months after the arthroscopic intervention.Results: Post-RC arthroscopy results showed significant improvements in upper extremity ROM, muscle strength, hand grip strength, 9-HPT, Tampa, BDI, SPADI, and Constant-Mur-ley Score compared to pre-arthroscopy measurements. Spatiotemporal parameters such as total weight transfer, step cycle duration, double stance duration, step length, gait cycle length, foot angle, and cadence values were highly significant in both operated and non-operated extremities after arthroscopic surgery (p<0.01). However, hindfoot pressure analysis and swing phase values were significant only on the operated side after arthroscopic surgery (p<0.05).Conclusion: Prior to RC arthroscopy, individuals exhibited kinesiophobia, depression, reduced functional capacity, balance asymmetry, decreased mobility, and, consequently, spatiotemporal parameter asymmetry between the extremities. Gait disturbances (lengthened swing phase, decreased step length, increased foot angle), balance loss, and arm sway asymmetry were also evident before RC arthroscopy. Based on these findings, we suggest incorporating balance and gait training into the early rehabilitation program after RC arthroscopy.
Geç Başlayan, Soliter Kemik Metastazı İle Prezente Olan Proksimal Humerus Lezyonu: 12 Yıllık Remisyondan Sonra Tanısal Bir Zorluk
(2025) Deniz, Gülnihal; Esmez, Omer; Esmez, Merve Yıldız
Meme kanseri kadınlarda en sık görülen tümörlerden biridir. Her sekiz kadından biri hayatının bir noktasında bu hastalıkla karşılaşabilir ve metastaz, uzun yıllar süren remisyondan sonra bile gelişebilir. Bu olgu sunumunda, 2012'nin başlarında sol memede karma tip (invaziv duktal ve lobüler) karsinomu teşhisi konulan ve 12 yıl remisyon boyunca modifiye radikal mastektomi ve adjuvan tedaviler uygulanan 60'lı yaşlarındaki bir kadında sağ omuzda ağrı ve şişlikle ortaya çıkan nadir bir humerus metastazı anlatılmaktadır. Pozitron emisyon tomografisi görüntüleme, proksimal sağ humerusta hipermetabolik bir lezyon ortaya koydu. Manyetik rezonans görüntüleme ve biyopsi, metastatik meme kanserini gösteren kötü huylu bir epitel tümör ortaya koydu. Hastaya palyatif radyoterapi uygulandı ve sistemik tedavi olarak ribociclib (Valamor) başlandı. Ancak, tedavi nedeniyle ellerde ve yüzde yaygın kaşıntı ve vitiligo benzeri cilt değişiklikleri gelişti. Bu vaka, meme kanseri hastalarında uzun dönem klinik ve radyolojik takibin önemini ve geç dönemde ortaya çıkabilecek iskelet metastazlarına karşı dikkatli olunması gerektiğini vurgulamaktadır.
How Does Kinesiophobia Affect Short- and Long-Term Gait Parameters in Individuals with Total Knee Arthroplasty Surgery
(Acta Medica Belgica, 2022) Deniz, Gulnihal; Bilek, Furkan; Esmez, Omer; Gulkesen, Arif
Delays in weight transfer due to various fears after Total knee arthroplasty (TKA) surgery negatively affect recovery. Therefore, the presence of kinesiophobia is essential for the success of the treatment. This study was planned to investigate the effects of kinesiophobia on Spatio-temporal parameters in patients who underwent unilateral TKA surgery. This study was a prospective and cross-sectional study. Seventy patients with TKA were assessed preoperatively in the 1st week (Pre1W) and postoperatively in the 3rd month (Post3M) and 12th month (Post12M). Spatiotemporal parameters were assessed using the Win-Track platform (Medicapteurs Technology, France). The Tampa kinesiophobia scale and Lequesne index were evaluated in all individuals. A significant relationship was found between the Pre1W, Post3M, and Post12M periods and Lequesne Index scores (p<0.01), and this relationship was in favor of improvement. In the Post3M period, kinesiophobia increased compared to the Pre1W period, and kinesiophobia decreased effectively in the Post12M period (p<0.01). The effect of kine-siophobia was evident in the first postoperative period. In the correlation analyses between spatiotemporal parameters and kinesiophobia, significant negative correlations were observed (p<0.01) in the early postoperative period (Post3M). Evaluating the effectiveness of kinesiophobia on Spatio-temporal parameters at different time intervals before and after TKA surgery may be necessary for the treatment process.
Relationship Between Recurrent Colorectal Cancer and EGFR Inhibitor-Induced Dermatological Side Effects: A Focus on Paronychia
(BMJ Publishing Group, 2026) Esmez, Omer; Esmez, Merve Yildiz; Deniz, Gulnihal
This case describes a woman in her mid-40s with recurrent colorectal cancer who developed severe dermatologic toxicity during panitumumab-based therapy. Three months after treatment initiation, she developed a diffuse acneiform eruption, pronounced xerosis and painful periungual inflammation with exuberant granulation tissue consistent with epidermal growth factor receptor (EGFR)-inhibitor-induced paronychia. Multidisciplinary, guideline-concordant supportive care (including prompt topical measures and short-course systemic therapy) achieved symptom control and allowed continuation of anticancer treatment. This report underscores the importance of early recognition and structured management of EGFR-inhibitor toxicities to prevent treatment disruption and preserve quality of life.
Small Round Blue Cell Sarcoma of the Left Humerus in a Pregnant Patient: Clinical Course of a Rare Aggressive Soft Tissue Tumor
(Emergency Medicine Physicians Assoc Turkey, 2025) Esmez, Omer; Deniz, Gulnihal
Small round blue cell tumors (SRBCT) represent a heterogeneous group of aggressive tumors with overlapping histological features, often requiring complex immunohistochemical and molecular studies for accurate diagnosis. Their occurrence during pregnancy poses significant diagnostic and therapeutic challenges, particularly when located in rare anatomical sites such as the humerus. We present the case of a 21-year-old pregnant woman at 31 weeks of gestation who was admitted with progressive pain and swelling in the left upper extremity. MRI revealed a large, intramedullary soft tissue mass in the mid-diaphysis of the left humerus with extension to adjacent musculature and neurovascular structures. Initial histopathological evaluation identified a poorly differentiated SRBCT. Despite extensive immunohistochemical work-up, a definitive diagnosis, necessitating advanced molecular analysis, remained elusive. The patient underwent cesarean delivery at 33 weeks due to obstetric indications. Subsequent PET-CT imaging demonstrated multiple hyper-metabolic lesions consistent with metastatic disease. Chemotherapy with the VAC regimen was initiated following postpartum stabilization. This case underscores the complexity of diagnosing SRBCT during pregnancy and highlights the importance of multidisciplinary collaboration. Early recognition, thorough histopathological and molecular evaluation, and individualized oncologic and obstetric management are critical for optimizing maternal and fetal outcomes.
Spatiotemporal Parameters of the Operated and Non-Operated Knees Before and After Unilateral Total Knee Arthroplasty (Vol 91, Pg 192, 2022 )
(Elsevier Ireland Ltd, 2024) Bilek, Furkan; Deniz, Gulnihal; Esmez, Omer; Belhan, Oktay
Tamoxifen-Induced Hepatotoxicity and Symptomatic Tarlov Cyst in a Breast Cancer Survivor – Coexistence or Consequence
(Via Medica, 2025) Esmez, Omer; Deniz, Gulnihal; Esmez, Merve Yildiz
Invasive breast carcinoma is among the most prevalent malignancies affecting women globally. This case presents a 47-year-old female diagnosed with invasive breast carcinoma, treated with mastectomy, chemotherapy, targeted therapy, and hormonal therapy. During follow-up, she developed hepatic dysfunction attributed to tamoxifen and subsequently experienced lower back pain due to a Tarlov cyst. The case underscores the importance of comprehensive and sustained surveillance in breast cancer survivors for the early detection and management of treatment-related complications and musculoskeletal manifestations.
Turkernextv2: An Innovative CNN Model for Knee Osteoarthritis Pressure Image Classification
(MDPI, 2025) Esmez, Omer; Deniz, Gulnihal; Bilek, Furkan; Gurger, Murat; Barua, Prabal Datta; Dogan, Sengul; Tuncer, Turker
Background/Objectives: Lightweight CNNs for medical imaging remain limited. We propose TurkerNeXtV2, a compact CNN that introduces two new blocks: a pooling-based attention with an inverted bottleneck (TNV2) and a hybrid downsampling module. These blocks improve stability and efficiency. The aim is to achieve transformer-level effectiveness while keeping the simplicity, low computational cost, and deployability of CNNs. Methods: The model was first pretrained on the Stable ImageNet-1k benchmark and then fine-tuned on a collected plantar-pressure OA dataset. We also evaluated the model on a public blood-cell image dataset. Performance was measured by accuracy, precision, recall, and F1-score. Inference time (images per second) was recorded on an RTX 5080 GPU. Grad-CAM was used for qualitative explainability. Results: During pretraining on Stable ImageNet-1k, the model reached a validation accuracy of 87.77%. On the OA test set, the model achieved 93.40% accuracy (95% CI: 91.3-95.2%) with balanced precision and recall above 90%. On the blood-cell dataset, the test accuracy was 98.52%. The average inference time was 0.0078 s per image (approximate to 128.8 images/s), which is comparable to strong CNN baselines and faster than the transformer baselines tested under the same settings. Conclusions: TurkerNeXtV2 delivers high accuracy with low computational cost. The pooling-based attention (TNV2) and the hybrid downsampling enable a lightweight yet effective design. The model is suitable for real-time and clinical use. Future work will include multi-center validation and broader tests across imaging modalities.