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Öğe Auricular muscormycosis: A case report(2007) Topçu, İsmail; Tuzcu, Alpaslan; Oktay, Faruk M.; Kılınç, Nihal; Aşkar, İbrahimMukormikozis nadir görülen safrofitik bir hastalıktır; invaziv ve hızlı bir seyir gösterir. Diabetes mellitus ya da kan diskrazileri gibi immün sistemin bozulduğu hastalarda ya da immünosupresif tedavi alanlarda görülür. Kontrol edilemeyen diyabetik ketoasidozlu 17 yaşındaki kadın hastada, sağ auriküla ve dış kulak yolunda siyah renkli lezyon oluşumu gözlendi. Fizik muayenede dış kulak yolu, auriküla ve buna komşu deri bölgesinde nekroz vardı. Hastada aynı zamanda lezyonla eşzamanlı sağ fasyal sinir paralizisi izlendi. Nekrotik dokular debride edildikten sonra, alınan doku örneklerinde yapılan mikrobiyolojik ve histopatolojik incelemede non-septat hif saptandı. Ameliyat sonrasında sistemik amfoterisin B tedavisi uygulandı. Hasta yedinci gün kaybedildi.Öğe Effects of antineoplastic agents on the peripheral nerves under a surgical tissue expansion procedure: An experimental study(Wiley, 2006) Oktay, M. Faruk; Aşkar, İbrahim; Yıldırım, Ayşe; Gürlek, Ali; Akkuş, Murat; Topçu, İsmail; Meriç, Faruk; 0000-0001-5708-4813Background. Elongation of peripheral nerve by the use of a tissue expander is helpful to repair nerve defects. This study was designed to investigate the effects of some antineoplastic agents on the peripheral nerves under a surgical tissue expansion procedure. Materials and Methods. Twenty-five Wistar rats were used in this study. Following the exposition of the sciatic nerve and placement of two 10/0-nylon sutures in the epineurium 20 mm apart, a tissue expander was then placed under it. Inflation of the expander was immediately accomplished by the separate percutaneous injections of 6, 6, and 8 ml for every 3 min under general anesthesia. The expander was fully deflated at the end of each 3 min The distance between two sutures was measured 1 h later to measure the rate of elongation. Rats were randomly divided into five groups (according to the administered drugs), each consisting of five rats (10 sciatic nerves). Normal saline (1 ml) in the control group (group 1), cyclophosphamide (15 mg/kg) in the group II, cisplatinum (3 mu g/kg) in the group III, mitomycin-C (0.5 mg/kg) in the group IV and 5-fluorouracil (10 mg/kg) in the group V were injected intravenously. Intravenous injections of drugs were performed via the tail vein 30 min before expansion, 48 and 96 h after removal of expander. The incision was reopened on the third and seventh postoperative days, and five sciatic nerves of each group were exposed and then the pinching test was performed to measure regeneration distance. Electro-neurographic changes were recorded. The expanded portion of the sciatic nerve between two sutures was harvested for histological evaluation. Results. There is no significant difference between the elongation rates of all groups (P < 0.05). Histologic evaluation showed that inflammatory changes, vacuolization, intraneural edema, demyelination, axonal changes in the control group, the cisplatinum group and the mitomycin-C group. These changes were significantly decreased in the cyclophosphamide group and the 5-fluorouracil group. In the cyclophosphamide group and the 5-fluorouracil group, the amplitude of compound action potential (CAP) values were significantly higher and the latency was significantly shorter (P > 0.05). Conclusion. We believed that cyclophosphamide and 5-fluorouracil may be helpful in tissue expansion of peripheral nerves, by decreasing the effects of the ischemia-reperfusion injury on the expanded peripheral nerves.Öğe Effects of some pharmacological agents on the survival of unipedicled venous flaps: An experimental study(Wiley-Blackwell, 2001) Aşkar, İbrahim; Saray, Aydın; Gürlek, Ali; Sevin, Kutlu; Sabuncuoğlu, Bizden TavilClinical and experimental studies have been conducted to improve the survival of venous flaps, As a result of these studies, although various survival mechanisms were raised, none obtained satisfactory information. Venous stasis, and the resultant venous thrombosis, is a factor that decreases the survival of venous flaps. In this study, we evaluated the effects of two antiinflammatory agents, etodolac and etofenamate, on the survival of unipedicled venous flaps. In this study, 35 male New Zealand white rabbits (3,500-4,000 g) (70 ears) were used. Perichondrocutaneous flaps, 3 x 4.5 cm in size, were designed and raised, keeping the central veins intact in the middle of venous flap. Central arteries and nerves were ligated and transected both proximally and distally, to prepare unipedicled venous flaps. A silicone sheet was placed between the cartilage tissue and flap, to prevent blood flow and revascularization beneath. The subjects were divided into seven groups, consisting of five rabbits (10 ears). In the negative control group (group 1), the single vascular pedicle of venous flaps, central veins were ligated and flaps sutured into their own place as the composite graft. In the positive control group (group 11), after venous flaps were prepared, normal saline, 0.2 mL, was given subcutaneously. In the first of five experimental groups (group III), unfractionated heparin (100 U/day) was given subcutaneously. In the second experimental group (group IV), etodolac (5 mg/kg/day) was given subcutaneously, In the third experimental group (group V), etophenamate (5 mg/kg/day) was given orally through a feeding tube. In the fourth experimental group (group VI), parnaparin (5 anti-Xa U/kg/day) was given subcutaneously. In the fifth experimental group (group VII), nadroparin (5 anti-Xa U/kg/day) was given subcutaneously, about 7 days postoperatively. At the eighth postoperative day, surviving areas of venous flaps were measured, and the results were evaluated by Kruskal-Wallis ANOVA and Mal Whitney U-test (P < 0.05). Biopsies were also taken from the flaps for histological evaluation of border of necrotic tissue, Surviving areas of unipedicled venous flaps were larger in experimental groups than those in negative and positive control group (P < 0.05). However, comparison of the experimental groups demonstrated no statistically significant dierence (P > 0.05). We concluded that all pharmacological agents used in the experimental groups succeeded in increasing the survival of unipedicled venous flaps. Survival of the unipedicled venous flap was higher in venous flaps than that of composite graft, clearly showing the importance of the venous pedicle.Öğe Etofenamat'ın random paternli sıçan dorsal deri flebi yaşayabilirliği üzerine etkisi(2000) Aşkar, İbrahim; Gürlek, Ali; Sabuncuoğlu, Bizden T.; Sevin, KutluDeri defektlerinin rekonstrüksiyonu için birçok deri flebi geliştirilmiştir. Distal flep nekrozu, özellikle uzun deri flepleri kaldırılırken, önemli bir problem olarak karşımıza çıkmaktadır. Bu nedenle, distal flep nekrozunu önlemek ve flep yaşayabilirliğini artırmak için birçok deneysel ve klinik çalışma yapılmıştır. Bu deneysel çalışmada, anti-inflamatuar ajan olan etofenamatın deri flebi yaşayabilirliği üzerindeki etkisi araştırıldı. Sprague-Dawley cinsi sıçanlarda, 3x10 cm boyutlarında pannikulus karnozus içeren kaudal tabanlı random paternli dorsal deri flebi kaldırılıp, yerine iade edildi. Kontrol grubuna herhangi bir farmakolojik ajan verilmezken, deney grubuna postoperatif dönemde yedi gün boyunca etofenamat 10 mg/kg/gün, im olarak verildi. Yedinci günde deri fleplerinin yaşayan alanları ölçüldü ve sonuçlar "Student's t-test" ile değerlendirildi. Yaşayabilen flep oranları etofenamat grubunda %83.27 ve kontrol grubunda %65.70 olarak bulundu. Etofenamatın flep yaşayabilirliğini, kontrol grubuna oranla, istatistiksel olarak anlamlı bir şekilde arttırdığı bulundu (p<0.05). Yedinci günde nekroz-canlı doku hattından biyopsi alındı ve histopatolojik değerlendirme yapıldı. Histopatolojik değerlendirmede, nekroz-canlı doku sınırında, her iki grupta da flep ile flep yatağı arasında damarlanmada artış görülürken, deney grubunda kontrol grubuna oranla daha az inflamatuar hücre infiltrasyonu izlendi.Öğe Giant pilomatrixoma(2002) Aşkar, İbrahim; Aytekin, Sema; Büyükbayram, HüseyinPilomatrixoma is most commonly seen in the head and neck region, occurring in the first two decades of life. It varies from 0.5 cm to 3 cm in diameter. Pilomatrixoma differentiates toward hair cells. Treatment of choice is excision. A 42-year-old woman presented with a giant painful pilomatrixoma, 5 cm in diameter, in the forearm. It had gradually grown larger over a period of years. Physical examination revealed a painful, red-brown colored, ulcerative, mobile mass, 50 mm in diameter, with surrounding hyperemia. Histopathological examination of the specimen provided the diagnosis of "pilomatrixoma". The mass was totally excised, and the resultant tissue defect was repaired with a full-thickness skin graft from the inguinal area. Two years later, there was no recurrence and the postoperative scar was cosmetically acceptable. Generally, there is no recurrence if the pilomatrixoma is totally resected. The case presented in this paper is of interest because the lesion had a large diameter, appeared in the fourth decade, and had a "faceted stone" appearance with perforation of the overlying skin. It is important to differentiate this lesion from a pilomatrix carcinoma.Öğe Letter to the editor(2000) Emiroǧlu, Murat; Aşkar, İbrahim; Can, Zeki; 0000-0002-3484-7686Dear Sir, A case of pseudolymphoma involving the preauricular area, tragus, and auricle is presented; it was treated with wide excision and prednisolone therapy. Pseudolymphoma is a benign lesion that simulates malignant lymphoma. It is a lymphomatous lesion thought to be a chronic inflammatory change that can be distinguished pathologically from a malignant lymphoma. The usual sites are skin, head, neck, lungs, and gastrointestinal tract .Öğe Protective effects of immunosuppressants and steroids against ischemia-reperfusion injury in cremaster muscle flap at microcirculatory level(Wiley, 2002) Aşkar, İbrahim; Bozkurt, MehmetThe sequential events between leukocytes and endothelium have significant implications in surgical procedures, trauma, vascular injury, and wound healing. These sequential events are mediated by free oxygen radicals, leukocytes, red blood cells, and endothelial cells. In this study, we investigated the protective effects of steroids and immunosuppressants against ischemia-reperfusion injury in cremaster muscle flaps at the microcirculatory level. In this experimental study, 50 male Sprague-Dawley rats, weighing about 120-130 g, were used. The rats were divided into five groups of 10 rats each: the control group (group 1, n = 10), methyl prednisolone group (group 2, n = 10), dexamethasone group (group 3, n = 10), cyclosporin A group (group 4, n = 10), and azathioprine (group 5, n = 10). Surgical procedures were divided into two stages. In the first stage, a cremaster muscle end-organ tube flap was created by extracting the testes and spermatic cord. The flap was placed into a subcutaneous tunnel in the anteromedial aspect of the ipsilateral limb. In the experimental groups, ischemia was performed by clamping the femoral artery and vein above and below the cremaster pedicle for 4 h. Then the clamps were removed, and perfusion of the cremaster muscle was allowed for 24 h, In the second stage, a round flap was obtained from the cremaster muscle tube-flap to evaluate microcirculation after 24 h of reperfusion, and dissected along its front wall using cauterization. Vessel diameter, red blood cell velocities, leukocyte activation, perfused capillaries, and endothelial edema index were measured and evaluated statistically. There was a significant decrease in the number of rolling, sticking, and transmigrating neutrophils of groups 2 (cyclosporin A), 4 (methylprednisolone), and 3 (azathioprine) (P < 0.05), whereas those of group 5 (dexamethasone) were not decreased (P > 0.05). There was a significant increase in the number of perfused capillaries of groups 2 (cyclosporin A), 4 (methylprednisolone), and 3 (azathioprine) (P < 0.05), nearly 0.75-, 0.5-, and 0.75-fold, respectively. We conclude that cyclosporin and azathioprine showed a protective effect on muscle tissue against ischemia-reperfusion injury by inhibiting leukocyte infiltration, and that methylprednisolone had a beneficial effect against ischemia-reperfusion injury by reducing the synthesis of eicosanoids, edema formation, and leukocyte infiltration. However, we believe that dexamethasone might have a salutary effect due to reducing the synthesis of eicosanoids, edema formation, and release of free oxygen radicals, but not due to leukocyte infiltration.Öğe Protective effects of some antineoplastic agents on ischemia-reperfusion injury in epigastric island skin flaps(Wiley-Liss, 2006) Aşkar, İbrahim; Oktay, Mehmet Faruk; Gürlek, Ali; Baç, BilselNeutrophil depletion has a beneficial effect on ischemic myocardium and skeletal muscle upon reperfusion. Antineoplastic agents reduce blood neutrophils effectively, and lead to neutrophil depletion. The purpose of this study was to investigate the effects of four antineoplastic agents in low doses (cyclophosphamide, cisplatinum, mitomycin-C, and 5-fluorouracil) on ischemia-reperfusion injury, using an epigastric island skin-flap model in rats. Fifty male Sprague-Dawley rats, weighing 250-300 g, were randomly divided into five groups, each consisting of 10 rats: control, cyclophosphamide, cisplatinum, mitomycin-C, and 5-fluorouracil groups. Epigastric island skin flaps (measuring 3.5 x 4 cm) were raised and subjected to 10 h of in situ ischemia, followed by 7-day reperfusion and evaluation. Treatment with antineoplastic agents (cyclophosphamide, cisplatinum, mitomycin-C, and 5-fluorouracil) was used to introduce neutropenia. Complete blood counts, cutaneous bleeding time, and skin-flap survival were evaluated. Additionally, levels of malonyldialdehyde (MDA), nitric oxide (NO), glutathione (GSH), glutathione peroxidase (GSH-Px), and superoxide dismutase (SOD) were measured from extracted skin tissue. Numbers of leukocytes and platelets were decreased in all experimental groups. However, neutropenia and thrombocytopenia were not seen. Cutaneous bleeding activity was prolonged in all experimental groups, but not above the normal value. MDA and NO levels were found to be lower in all four antineoplastic agent groups than in the control group, while GSH, GSH-Px, and SOD enzyme activities were significantly higher (P < 0.05). However, MDA and NO levels were significantly decreased in the cyclophosphamide and 5-fluorouracil groups, as compared to the cisplatinum and mitomycin-C groups (P < 0.01). Also, GSH, GSH-Px, and SOD enzyme activities were significantly increased in the cyclophosphamide and 5-fluorouracil groups, compared to the other two antineoplastic agent groups (P < 0.01). We conclude that antineoplastic agents have beneficial effects on ishemia-reperfusion injuries when their doses are carefully adjusted, by decreasing the number of leukocytes and platelets, and altering the activity of free oxygen radicals. (c) 2006 Wiley-Liss, Inc.Öğe Salutary effects of radiopaque contrast media on the survival of random-pattern skin flaps in the rat(Wiley, 2004) Aşkar, İbrahim; Bozkurt, Mehmet; Oktay, Mehmet Faruk; Gürlek, Ali; Keleş, CelalettinThe radiopaque contrast medium diatrizoate, has a vasodilator effect so that it is used in sudden-deafness secondary ischemic injury. However, ischemic problems are encountered, especially when longer flaps are elevated. A longer flap also has ischemic and relatively ischemic tissue, and may obtain some benefit from contrast media. Forty male Sprague-Dawley rats, weighing about 350-400 g, were used, and randomly divided into four groups (n = 10 rats each group): group 1 was the control, group 2 the diatrizoate, group 3 the iopamidol, and group 4 the iothalamate group. A rectangular 3 x 10 cm caudally based dorsal skin flap was elevated, and sutured back to its original place. In the control group, no pharmacologic agent was administered. Sodium-meglumine-diatrizoate 10 mg/kg/day was administered parenterally in the first experimental group (diatrizoate group); iopamidol 10 mg/kg/day in the second experimental group (iopamidol group); and iothalamate sodium 10 mg/kg/day in the third experimental group (iothalamate group) for 7 postoperative days. On postoperative day 7, all flaps were photographed, and the area of flap survival was measured by using a polar planimeter. The results were statistically evaluated with the Kruskal-Wallis test and Mann-Whitney U-test (P = 0.05). The mean flap survival ranged from 79% in the iopamidol group to 83% in the diatrizoate group, and was significantly greater in all experimental groups (P < 0.05) compared to the control group (59%). There was no significant difference between experimental groups (P < 0.05). We believe that radiopaque contrast media have a beneficial effect in improving skin flap viability when distal flap necrosis is a potential complication of longer flaps.Öğe Scapular melanoacanthoma(2002) Aşkar, İbrahim; Büyükbayram, HüseyinCutaneous melanoacanthoma is a rare benign epidermal melanocytic lesion. It occurs in the head and is similar to seborrheic keratosis or pigmented basal cell carcinoma. It grows slowly and is usually seen in elderly male patients. It rarely occurs on the back. A 55-year-old woman presented with a red-colored nodular lesion of her back. Four years previously it had been noted by the patient; it was a red colored nodular lesion and 0.5 cm in diameter at that time. It had enlarged and was now 4 cm in diameter. Previous biopsies had been diagnosed as basal cell carcinoma and it was for this reason she was seen. On physical examination, a painless, crusty, red-black-colored, mobile lesion, 4 cm in diameter, was observed. The lesion was totally excised, and repaired with a Limberg flap. The specimen was sent for histopathological examination, which revealed a diagnosis as a melanoacanthoma. No recurrence was seen 6 months later and the postoperative result was cosmetically acceptable.Öğe Subperiosteal tissue expansion: An experimental study(2003) Aşkar, İbrahim; Sabuncuoğlu, Bizden Tavil; Özbek, Mustafa Rıza; 0000-0002-0152-9761Periosteal flaps have been used to cover bone defects. There are no sufficient data on whether expanded periosteum can be used to repair bone defects after subperiosteal tissue expansion. In this experimental study, 14 male dogs, which were 2 years-old and weighed 14.5-16.0 kg, were used to investigate the repair of bony defects with expanded periosteum. Rectangular tissue expanders, measuring 50 mm in width, 70 mm in length, and 20 mm in height (volume: 20 ml) were used. The dogs were divided into two groups each of seven dogs: one control group and one experimental group. In each dog, a pocket, 50×70 mm in size, was prepared in parietal area, and a periosteal area, 30×40 mm in size, was marked out. A rectangular tissue expander was inserted into the pocket. In the control group, the tissue expanders were not inflated. On the seventh postoperative day, the tissue expander inflation with normal saline (5 ml per 2 days) was started in the experimental group. After 15 days, the previously marked out periosteal area was measured. A specimen was taken from this periosteal tissue for histopathological evaluation. A bone defect, 20×20 mm in size, was created beneath expanded periosteal tissue, and this defect was covered with the expanded periosteal tissue. After 15 days, a histopathological evaluation was carried out. Statistical analysis was carried out using the Mann-Whitney U-test. The area of periosteum expanded was more in the experimental group than that of the control group (p>0.05). After removal of the tissue expander, both in the control and subperiosteal tissue expansion group, osteoblastic lining of the expanded periosteum, increased vascularity, and granulation tissue was noted. Following 15 days, woven and lamellated bone tissue was formed both in the control and subperiosteal expansion group. In the subperiosteal expansion group, there was greater bone formation, the expanded periosteum was thickened, and thickened lamellated bone was covered by active osteoblasts. It is concluded that subperiosteal tissue expansion may be worthwhile to provide large periosteal flaps for the repair of large bone defects, by increasing osteogenic capacity.Öğe Superficial or deep implantation of motor nerve after denervation: An experimental study-superficial or deep implantation of motor nerve(Wiley, 2002) Aşkar, İbrahim; Sabuncuoğlu, Bizden Tavil; 0000-0002-0152-9761Neurorraphy, conventional nerve grafting technique, and artificial nerve conduits are not enough for repair in severe injuries of peripheral nerves, especially when there is separation of motor nerve from muscle tissue. In these nerve injuries, reinnervation is indicated for neurotization. The distal end of a peripheral nerve is divided into fascicles and implanted into the aneural zone of target muscle tissue. It is not known how deeply fascicles should be implanted into muscle tissue. A comparative study of superficial and deep implantation of separated motor nerve into muscle tissue is presented in the gastrocnel muscle of rabbits. In this experimental study, 30 white New Zealand rabbits were used and divided into 3 groups of 10 rabbits each. In the first group (controls, group 1), only surgical exposure of the gastrocnemius muscle and motor nerve (tibial nerve) was done without any injury to nerves. In the superficial implantation group (group 11), fibial nerves were separated and divided into their own fascicles. These fascicles were implanted superficially into the lateral head of gastrocnemius muscleaneural zone. In the deep implantation group (group 111), the tibial nerves were separated and divided into their own fascicles. These fascicles were implanted around the center of the muscle mass, into the lateral head of the gastrocnemius muscle-aneural zone. Six months later, histopathological changes and functional recovery of the gastrocnemius muscle were investigated. Both experimental groups had less muscular weight than in the control group. It was found that functional recovery was achieved in both experimental groups, and was better in the superficial implantation group than the deep implantation group. EMG recordings revealed that polyphasic and late potentials were frequently seen in both experimental groups. Degeneration and regeneration of myofibrils were observed in both experimental groups. New motor end-plates were formed in a scattered manner in both experimental groups. However, they were more dense in the superficial implantation group than the deep implantation group. It was concluded that superficial implantation has a more powerful contractile capacity than that of deep implantation. We believe that this might arise from the high activity of glycolytic enzymes in peripheral muscle fibers of gastrocnemius muscle, decrease in insufficient intramuscular guidance apparatus, and intramuscular microneuroma formation at the insufficient neuromuscular junction since the motor nerve had less route to muscle fibers.Öğe Surgical correction of postpneumonectomy syndrome by intrapleural expandable prosthesis in a child(2004) Özçelik, Cemal; Onat, Serdar; Aşkar, İbrahim; Topal, EnderWe report a case of postpneumonectomy syndrome in a 10-year-old boy operated on for right-sided destroyed lung 1 year previously. The treatment involved the insertion of saline-filled expandable prosthesis in the postpneumonectomy cavity. A favorable outcome was observed. We think that an intrapleural inflatable prosthesis has several advantages for postpneumonectomy syndrome seen in childhood.Öğe Teratogenic effect of trimethobenzamide: An experimental study(2005) Bayhan, Gökhan; Aşkar, İbrahim; Ketani, Muzaffer AydınIn the experimental and clinical studies, it was reported that many pharmacological agents had teratogenic effects. There has been no sufficient explanation about the effect of trimethobenzamide, which is an antinauseant agent commonly used in Turkey. Thirty Wistar albino female rats, 3-month-old, weighing 200–250 g, were used to search the teratogenic effect of trimethobenzamide. In estrus, female rats were bred to singly housed males overnight. On the morning, the female rats with positive vaginal lavage for sperm were accepted as in the first gestational day (gd) 0. Sperm-positive females were divided into five groups, including six rats, by collecting randomly. In the first trimester (gd 6–15), in the control group (n=6), normal saline 0.5 ml was given subcutaneously; in the experimental groups, trimethobenzamide (Emedur®) was given subcutaneously, in dose of 17, 34, and 51 mg/kg/day, respectively. At death (gd 20), all live fetuses were evaluated for external, visceral, and skeletal abnormalities. No congenital abnormality was macroscopically seen. There was no developmental abnormality. However, a dose dependent developmental retardation was seen in bone and cartilage tissue, and a dose reduction in fetal body weight. The developmental retardation was prominent especially in vertebrae, and extremities.Öğe Tuberculous parotitis: A review of seven cases(İstanbul Üniversitesi Tıp Fakültesi, 2007) Oktay, Mehmet Faruk; Aşkar, İbrahim; Yıldırım, Müzeyyen; Topçu, İsmail; Meriç, FarukObjectives: Tuberculous parotitis is rare even in countries where tuberculosis is widespread. We evaluated seven patients with tuberculous parotitis together with clinical and histopathologic findings, and management. Patients and Methods: In a period of 13 years, seven patients (5 males, 2 females; mean age 32 years; range 23 to 47 years) were diagnosed and treated for tuberculous parotitis. All the patients had a clinical suspicion of a parotid gland tumor. Results: The lesions were localized on the left in four patients, and on the right in three patients. The duration of disease varied from seven months to three years. The masses were localized, mobile, and measured 3 to 6 cm in diameter; one was fistulized. There was no evidence for active pulmonary tuberculosis. Chest radiograms showed old tuberculous lesions in two patients. The PPD skin test results were positive (>12 mm induration) in five patients (71%). Computed tomography or magnetic resonance imaging obtained in five patients showed mass formation suggesting a benign parotid gland tumor. Fineneedle aspiration cytology performed in three patients and cultivation performed in the fistulized case were all non-diagnostic. Superficial parotidectomy was performed in six patients and enucleation was performed in one patient. Histopathologic examination showed tubercles composed of macrophages, epithelioid cells and Langhans giant cells, and central caseous necrosis. Following diagnosis, all patients were treated with a fourdrug chemotherapy regimen. There was no evidence for recurrence within a mean of 15-month follow-up. Conclusion: Tuberculosis of the parotid gland should be considered in the differential diagnosis of patients presenting with a solitary tumor in the parotid gland.
