Breast cancer is the most common cancer type among women according to the World Health Organization data. While breast-conserving surgery has been increasingly performed in patients with early-stage breast cancer, unilateral or bilateral mastectomy is still performed in many patients. With the changes in mastectomy techniques and the development of breast reconstruction techniques over the years, today the aim of breast reconstruction is to create breast tissue in a shape and symmetry that will correct the anatomical defect that occurs after mastectomy, without affecting the patient's oncological treatment. Radiotherapy is applied to patients after breast-conserving surgery as well as selected patient groups after mastectomy. In addition, reconstruction methods can be recommended after mastectomy in a patient who has previously received radiotherapy treatment to the breast. The aim of radiotherapy is to improve local and regional control and increase survival rates. Radiotherapy will affect the expected cosmetic outcomes. Poor cosmetic results can be prevented by determination of correct surgical technique, reconstruction strategy, and new developing technologies.

Objectives: The extent of the surgical treatment for Graves’ disease (GD) has evolved from subtotal to total thyroidectomy. This study analyzes the extent of thyroidectomy for GD and its impact on recurrence and complications, focusing on the relationship between remnant thyroid tissue and recurrence in subtotal thyroidectomy, comparing our current approach with historic data spanning over three decades.
Methods: A retrospective analysis of 427 GD patients who underwent surgery at a tertiary hospital from 1988 to 2022. Patients were categorized into total/near-total thyroidectomy (TT, n=302) and subtotal thyroidectomy (ST, n=125). The groups were compared for demographics, postoperative complications, and recurrent hyperthyroidism rates. ROC analysis determined the remnant cut-off value for recurrence in the ST group.
Results: Age and sex were similar across groups. Recurrent hyperthyroidism was found in 8% of ST patients but none in the TT group (p<0.001). Transient hypoparathyroidism was higher in the TT group (16.9% vs. 0.8%; p<0.001). Persistent hypoparathyroidism and vocal cord paralysis rates were comparable. ST patients with recurrence had more remnant tissue (5.3±0.94 g vs. 3.4±1.34 g; p<0.01). The remnant tissue cut-off for predicting recurrence was 4 g (<4 g: 0%, ≥4 g: 17.8%; p<0.001).
Conclusion: Total thyroidectomy has lower recurrence rates than subtotal thyroidectomy without significantly increasing long-term complications. Remnant tissue larger than 4 g in subtotal thyroidectomy increases the risk of recurrence.

Objectives: To describe a novel technique for dissecting cadaver brains without damaging medial brain structures and surfaces, ensuring preservation for neuroanatomical study and training.
Methods: Ten adult cadaveric brains were dissected using the supracerebellar suprapineal approach under an operative micro-scope with 6x to 40x magnification. This approach allowed for the separation of the brain into two hemispheres while providing direct visualization of the third ventricle and preserving midline structures.
Results: The supracerebellar suprapineal approach enabled accurate and feasible dissection of the hemispheres without causing damage to the medial brain structures. All midline structures, including the third ventricle, were preserved, producing high-quality specimens for anatomical study.
Conclusion: The supracerebellar suprapineal approach offers a significant advancement in the technique for hemispheric brain dissection, ensuring the preservation of medial brain structures and providing superior specimens for neurosurgical training and study.

Objectives: Mechanical thrombectomy (MT) has revolutionized the treatment of acute ischemic stroke (AIS). Still, the efficacy and safety in patients older than 85 years of age are not conclusive by the present randomized controlled trials’ data (RCT). Aging is a multifactorial process and the impact of MT on this specific population needs to be further analyzed.
Methods: We retrospectively reviewed 169 patients, ≥85 years old who presented with AIS and underwent MT between 2018 and 2023. Perfusion-weighted imaging (PWI) and software data were also analyzed. Good functional outcome was defined as modified Rankin scale (mRS) ≤2 and assessed at 30 and 90-day follow-ups. Feasibility and safety assessments included First Pass Effect (FPE); hemorrhagic transformation (HT) evaluated according to European Cooperative Acute Stroke Study radiological classification.
Results: Patients were subdivided into two groups (85-90 and >90 years old). A total of 107 (66%) patients had baseline PWI software on onset and median ADC value of 24.19±32.70. Anterior circulation comprised 14.3% (n=24) of the patients; 19.6% (n=33) had middle cerebral artery (MCA) M2, 1.8% (n=3) MCA M3 and 1.8% (n=3) anterior cerebral artery occlusion. Posterior circulation only comprised basilar artery occlusions (n=18). The 3-month mRS of 0-2 was 27% and mRS of 6 was 23.1%. Overall HT was found in 29.2% (n=49) of the patients, but HT1 constituted the highest ratio (70.2%; n=33).
Conclusion: Sub-analysis of several RCTs considered age as a limiting factor for MT in elderly patients. We suggest MT should be considered safe in well-selected candidates older than 85 years.

Objectives: To assess the efficacy of endovascular treatment and clinical outcomes in individuals with symptomatic intracranial
stenosis who had not responded adequately to medical intervention.
Methods: The study included 32 patients who received endovascular treatment due to high-grade (70%-99% severity) intracranial atherosclerotic stenosis from December 2021 to December 2023. The patients had not experienced any acute ischemic or hemorrhagic infarction within the last three weeks, had a Modified Rankin Scale score of ≤3 at baseline, and developed a transient ischemic attack or non-disabling stroke despite having received the best medical treatment. Technical and clinical success, mortality, and complication rates were recorded.
Results: Of the 32 patients included in the study, 62.5% (n=20) were male, and the mean age was 66.4±10.09 years. Stenting was performed on the intracranial internal carotid artery in 43.8% (n=14) of the patients, the intradural vertebral artery in 37.5% (n=12), the middle cerebral artery in 12.5% (n=4), and the basilar artery in 6.3% (n=2). The technical success rate was 100%, and the clinical success rate was 87.5%. The mean degree of stenosis before the procedure was 91.7±6.3%, and the degree of residual stenosis after the procedure was 22.1±4.7%. The Neuroform Atlas® stent system was used in 18 cases (56.3%), Credo® stents in eight (25%), coronary balloon-expandable stents in four (12.5%), and the LVIS® stent system in two (6.3%). Twenty-eight (87.5%) patients did not have any symptoms in the first 30 days, while two (6.2%) patients had an ischemic stroke, one (3.1%) patient had a hemorrhagic stroke, and one (3.1%) died.
Conclusion: Endovascular treatment in carefully selected patients, a tailored selection of treatment subtypes, and an experienced multidisciplinary team overseeing the patient before, during, and after the procedure have the potential to provide safe and effective treatment for patients with symptomatic intracranial atherosclerotic stenosis.

Objectives: The study's goal is to find out if there is a link between the results of the 6-minute walk test (6MWT) done before surgery and the chance of getting pneumonia after surgery in people with stage I lung cancer who are having a video-assisted thoracoscopic lobectomy.
Methods: We conducted a retrospective analysis on data from 194 patients with lung cancer who underwent VATS lung resection between January 2020 and August 2023. We assessed the preoperative 6MWT findings and the likelihood of developing postoperative pneumonia using a logistic regression model.
Results: Pneumonia developed in 23 patients (11.9%) in the early postoperative period. Risk factors led to the exclusion of 12 patients leaving 11 patients in the study. Eight of the patients were male three were female and the average age was 51±6 years. Postoperative pneumonia was observed to be statistically significantly more likely to occur in those whose 6MWT outcomes were less than 300 meters (p<0.05).
Conclusion: We found that patients who underwent VATS lung resection due to pulmonary malignancy and had a preoperative 6MWT result below 300 meters were at risk for developing postoperative pneumonia.

Objectives: Inflammatory bowel diseases (IBD) are chronic, immune-mediated disorders of the gastrointestinal system. Pancreas can be affected in IBD patients with a wide array of clinical conditions including acu-te pancreatitis, abnormalities of pancreatic duct and pancreatic insufficiency. Pancreatic steatosis (PS) is an important but often overlooked pathology of pancreas. In this study, we aimed to investigate the prevalence of PS in IBD patients to reveal the possible association in between in a patient group already prone to pancreatic disease involvement.
Methods: This retrospective study included 153 IBD patients who had a computed tomography scan in the last five years to evaluate the presence of PS. PS was defined as a pancreas/spleen attenuation ratio of below 0.70 in accordance with previous studies available in the literature. Demographic data, IBD subtype and treatment modality used for IBD were recorded and analyzed.
Results: 78 patients had Crohn’s disease and 75 patients had ulcerative colitis. Presence of PS in IBD patients was 23.5%. Age and treatment modality were found to be related to PS presence. Logistic regression analysis revealed a statistically significant relationship between PS and advanced age (p=0.000) but not with treatment modality (p=0.290).
Conclusion: PS is an important pathology of the pancreas with serious complications. In an already burdensome disease like IBD, PS can add more challenges to patient management. Although a direct correlation between PS and IBD prognosis is not established in current literature, evaluation of IBD patients for PS will help in prevention and management of PS-related conditions which will improve the overall well-being of IBD patients.

Objectives: Inflammatory bowel disease (IBD) in children is a chronic condition that affects the psychosocial status and physical activities of children and their parents. This study aimed to investigate the impact of IBD on the quality of life of adolescents and their families and the variability of behavioral and emotional adjustment issues compared to a healthy control group.
Methods: This study was designed as a prospective controlled study. A total of 159 cases were included, consisting of 84 IBD patients aged between 8-17 years and 75 healthy control subjects. All children and their parents included in the study were administered the Pediatric Quality of Life Inventory (PedsQL) and the Strengths and Difficulties Questionnaire (SDQ) for adolescents and parents.
Results: The median ages of the IBD children and the control group were 13.5 and 13, respectively. Of all 154 cases, 87 were female and 72 were male. Among the patients diagnosed with IBD, 39 had Crohn's disease, 37 had ulcerative colitis, and 8 had indeterminate colitis. It was observed that both the PedsQL and SDQ scores of children and parents with IBD were statistically significantly lower in both physical and psychosocial scoring (p=0.01 and p<0.001, respectively). A weak but statistically significant correlation was observed between the PedsQL and SDQ results applied to parents (rho=-0.214, p=0.007) and children (rho=-0.208, p=0.008).
Conclusion: The lower PedsQL and SDQ scores in children with IBD and their parents suggest that IBD negatively affects psychosocial, physical, and behavioral adaptations in children.

Objectives: Despite being recognized for a long time as a characteristic of Parkinson's disease (PD), pseudobulbar affect (PBA) is still a symptom that is underdiagnosed and undertreated. This study aimed to assess the association between PBA and various mood disturbances, as well as the impact on quality of life in PD patients.
Methods: Sixty-eight patients with PD were enrolled in this study. Their demographic and clinical features, including age, gender, education, smoking, lateralization and duration of the disease, and comorbidity, were recorded. The scores on the Unified Parkinson’s Disease Rating Scale (UPDRS), Hoehn-Yahr Scale, The Mental Component Summary (MCS-12), the Physical Component Summary (PCS-12), The Montreal Cognitive Assessment, and Beck Depression Inventory were evaluated. The Center for Neurologic Study-Lability Scale (CNS-LS) was used to explore PBA.
Results: There were 12 patients (17%) with CNS-LS scores of ≥13, and 4 patients (5%) with CNS-LS scores of ≥4. BDI scores demonstrated a strong positive correlation with CNS-LS scores (Spearman correlation coefficient=0.64, p<0.001), and MCS-12 scores showed a significant negative correlation with CNS-LS scores (Spearman correlation coefficient=-0.70, p<0.001). The multivariate linear regression analysis showed that lower MCS-12 scores are related to higher CNS-LS scores, and higher BDI scores are also linked to higher CNS-LS scores.
Conclusion: Our results indicate that elevated depressive symptoms correspond with increased CNS-LS scores, while a lower quality of mental health is also linked to higher CNS-LS scores. These findings highlight the influence of mood and mental health status on PDA among patients with PD.

Objectives: Nonsmall cell lung cancer (NSCLC) accounts for about 85% of all lung cancers. Asymmetric dimethylarginine (ADMA) is an emerging molecule that is highlighted in carcinogenesis and tumor progression in lung cancer. Since elevated concentrations of ADMA are observed in lung cancer patients, we aimed to explore its associations with inflammation markers and established
prognostic indices.
Methods: 78 newly diagnosed non-small cell lung cancer patients who were presented with brain metastases at the initial admission and 41 Stage 1 patients with NSCLC were included in the study. ADMA concentrations among the groups were correlated. Further, the relationship between ADMA levels and the other inflammatory markers was analyzed.
Results: ADMA levels were significantly higher in the group of NSCLC patients with brain metastases than in the Stage 1 patients control group (p<0.001). A significant negative correlation was found between ADMA levels and BMI, albumin and hemoglobin (p<0.001), whereas it was positively correlated with platelet, WBC, neutrophil-to-lymphocyte ratio, RDW, RDW/albumin ratio, LDH, CRP, fibrinogen, platelet, and CRP/albumin ratio (p<0.001).
Conclusion: Increased circulating concentrations of ADMA were significantly correlated with higher NLR, CRP and LDH; which were accepted as indicators of poor prognosis in NSCLC patients. ADMA might contribute to tumor growth and dissemination via systemic inflammatory pathways.

Objectives: Cancer or its treatment can have direct or indirect effects on sexual functions. Routine assessment of sexual functioning is essential in cancer patients to identify sexual problems and provide counseling to patients about these issues. This study aimed to investigate the validity and reliability of the Turkish version of the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Sexual Health 22 prepared for the assessment of sexual function in cancer patients.
Methods: The sample of the study consisted of 201 patients, aged between 18-75, who received inpatient or outpatient treatment and treatment follow-up in the medical oncology unit of two private hospitals in Istanbul, regardless of cancer type, treatment stage and form. Language equivalence has been achieved. The validity of the scale was evaluated by factor analysis and the suitability of the model was determined by Goodness of Fit Indices. For the reliability of the scale, internal consistency was tested with Cronbach's alpha value. For consistency, a relationship was sought between the data taken 3 weeks apart using the test-retest method and the Spearman Correlation Test.
Results: Goodness of Fit Indices; It was calculated as Comparative Fit Index (CFI)=0.98, Tucker-Lewis Index (TLI)=0.98 Goodness of Fit Index (GFI)=1.32, Root Mean Square Error of Approximation (RMSEA)=0.04, Standardized Root Mean Square Residual (SRMR)=0.088. All factor loadings were found statistically significant with p<0.0001. In the internal consistency analysis, Cronbach alpha values of 0.91, 0.79 and 0.88 were obtained for sexual satisfaction, sexual pain subscales and all questions, respectively, and all groups were found to be reliable. In the Spearman Correlation Test used for consistency analysis, all coefficients were calculated above 0.7 and strong relationships were observed between the data. It was concluded that the scale was consistent in all areas.
Conclusion: All data obtained from the Turkish version of the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Sexual Health 22 are valid and reliable.

Objectives: Atopic skin plays a significant etiological role in the development of prurigo nodularis (PN). In addition to atopic dermatitis (AD), atopic skin diathesis without eczema can also contribute to the development of PN due to its association with itching. This study aims to evaluate PN in terms of AD/atopic skin diathesis, associated comorbidities, and clinical findings.
Methods: Patients diagnosed with PN based on clinical and histopathological findings between 2014 and 2024 were included in the study. Associated diseases that could contribute to the etiology of pruritus were recorded as comorbidities. The diagnosis of AD was evaluated using the Hanifin-Rajka’s diagnostic criteria and atopic skin diathesis using the Erlangen Atopy Score. Patients were classified as atopic and non-atopic groups, and these groups were compared in terms of demographic and clinical findings.
Results: The study included a total of 47 patients, of whom 15 (31.9%) were male and 32 (68.1%) were female. At least one comorbidity was identified in 89.4% (n=42) of the patients, and multiple comorbidities were found in 34% (n=16). Atopic dermatitis and/or atopic skin diathesis were present in 55.3% (n=26) of the patients. Among these, 53.8% (n=14) were diagnosed with AD, while 46.2% (n=12) had only an atopic skin diathesis. Compared to the non-atopic group, the atopic group had a lower median age (p=0.001) and higher serum total IgE levels (p=0.031).
Conclusion: In addition to AD, atopic skin diathesis without eczema also appears to play an important role in the etiology of PN. The lower age and higher IgE levels in patients are factors associated with atopic predisposition.

Objectives: Type 2 diabetes mellitus is a disease with a rising prevalence worldwide. Person-centered treatment factors, including comorbidities and treatment goals, should be considered in determining the pharmacological treatment of type 2 diabetes. ChatGPT-4 (Generative Pre-trained Transformer), a large language model, holds the potential performance in various fields, including medicine. We aimed to examine the reliability, quality, reproducibility, and readability of ChatGPT-4's responses to clinical scenarios about the medical treatment approach and management of type 2 diabetes patients.
Methods: ChatGPT-4’s responses to 24 questions were independently graded by two endocrinologists with clinical experience in endocrinology and resolved by a third reviewer based on the ADA(American Diabetes Association) 2023 guidelines. DISCERN (Quality Criteria for Consumer Health Information) Measurement Tool was used to evaluate the reliability and quality of information.
Results: Responses to questions by ChatGPT-4 were fairly consistent in both sessions. No false or misleading information was found in any ChatGPT-4 responses. In terms of reliability, most of the answers showed good (87.5%), followed by excellent (12.5%) reliability. Reading Level was classified as fairly difficult to read (8.3%), difficult to read (50%), and very difficult to read (41.7%).
Conclusion: ChatGPT-4 may have a role as an additional informative tool for type 2 diabetes patients for medical treatment approaches.

Objectives: Adipsin and leptin are adipokines that link adipose tissue dysfunction and increased fat accumulation to obesity-related metabolic disorders. This study aimed to assess the effects of sitagliptin/metformin versus metformin monotherapy on the levels of adipsin, leptin, and lipid profile in type 2 diabetic patients.
Methods: This comparative case-control study included 120 participants divided into four groups: healthy participants, newly diagnosed type 2 diabetic patients, metformin-treated patients, and sitagliptin/metformin-treated patients.
Results: Newly diagnosed type 2 diabetic patients revealed significantly lower adipsin levels, with concomitant higher leptin levels compared to the healthy control group. Adipsin levels were significantly higher and leptin levels were significantly lower in both drug-treated patients compared to newly diagnosed group. Compared to healthy control, there were significantly higher levels of hemoglobin A1c (HbA1c), fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), very-low-density lipoprotein (VLDL), low-density lipoprotein (LDL), and atherogenic index (AI) in the newly diagnosed patients, with significantly lower high-density lipoprotein (HDL) levels. Interestingly, in both treated groups, HbA1c, FBG, TC, TG, VLDL, and AI were significantly decreased compared to newly diagnosed patients. Concomitantly, there are significantly higher levels of HDL in drug-treated group compared to untreated patients.
Conclusion: Adipsin is low and leptin is high in diabetic patients which support its possible use as a biomarker for type 2 diabetes. Accordingly, the modification of these adipokines, via the use of drug therapy, has advantageous effects on the cardiovascular system in diabetic patients. Specifically, sitagliptin/metformin regulates adipsin, leptin, and lipid profile to a greater extent than metformin.

Parathyroid adenoma is the most common cause of primary hyperparathyroidism and rarely reaches huge sizes. As the gland enlarges it may exhibit atypical morphology and extension to the mediastinum which may complicate the excision of the tumor while preserving the capsular integrity. We present a 35-year-old male patient who was referred to our department with a complaint of severe hypercalcemia. Neck ultrasound and parathyroid scintigraphy revealed an adenoma of 45x25 mm in size in the left parathyroid lobe extending to the retrosternal area. The patient underwent an uneventful parathyroidectomy. The patient remained well with no evidence of biochemical recurrence during the 4-year follow-up. Here, we presented a very original case of one of the largest parathyroid adenomas (8 cm) with atypical configuration (having multiple spicular extensions from the main body) ever reported in the literature which was completely retrieved from the posterior mediastinum via cervical route.

Inguinal masses have a large variety of causes, ranging from inguinal hernias to soft tissue sarcomas. One of the less prevalent causes is vascular origin. Venous aneurysms, unlike their arterial counterparts, are seen seldomly and experience in management of these cases is scarce. A 32-year-old male patient was referred to our clinic due to an enlarging left inguinal mass with a preliminary diagnosis of inguinal hernia. Doppler ultrasonography revealed an eight cm in diameter aneurysmatic Great Saphenous Vein segment located just below the inguinal ligament. Dilated segment was excised without complete resection. Removal of the dilated segment and performing complete venous resection depending on venous valvular failure constitutes surgical repair of Great Saphenous Vein aneurysms. Surgical approach should be primarily selected if Great Saphenous Vein aneurysm is detected due to its debilitating nature and possible rupture.

Pheochromocytoma is a rare tumor originating from the adrenal gland, characterized by the secretion of catecholamines. Due to the risk of hypertensive crises associated with catecholamine release, surgical procedures in pheochromocytoma patients are risky. In this case report, laparoscopic appendectomy for acute appendicitis in a patient who has pheochromocytoma will be presented. A 49-year-old female patient presented with abdominal pain. Physical examination showed guarding and rebound in the right lower quadrant. The patient, who had leukocytosis in the investigations, showed signs of acute appendicitis and a 5 cm right adrenal mass on the abdominal computed tomography. A previous abdominal magnetic resonance imaging by the endocrinology department six months ago revealed a 39x32 mm mass in the right adrenal gland and elevated urinary catecholamine levels. It was learned that the patient had not attended follow-up appointments during this period. The patient was consulted by endocrinology and an emergency laparoscopic appendectomy was performed. The patient, discharged on the 2nd day after surgery, did not experience any complications. The patient was referred to endocrinology, and preoperative preparations for pheochromocytoma surgery were initiated. In cases of emergency in patients diagnosed with pheochromocytoma emergency surgery can be performed with appropriate preoperative preparation.

Pregnancy-related spontaneous coronary artery dissection (P-SCAD) is a life-threatening condition that occurs during or after pregnancy, is rare and can be overlooked. It is one of the most important causes of pregnancy-related acute myocardial infarction. A 25-year-old female patient was admitted with a complaint of chest pain in her 37th week of pregnancy. There was nothing specific in her medical history except for a cesarean section, performed 2 years ago. There was diffuse ST-segment depression, and ST-segment elevation in leads V1, V2, and AVR. The patient was evaluated multidisciplinary and it was decided to perform a cesarean section and then urgently perform coronary angiography (CAG). Dissection within the lumen of the left anterior descending artery (LAD) was observed. The LAD was filling retrogradely from the right coronary artery, but no antegrade filling was observed (Type 2 SCAD). The patient, whose hemodynamics were stable and whose electrocardiography (ECG) showed no change, was monitored intubated, and stabilized in the intensive care unit (ICU) to minimize cardiac demand and reduce the risk of further myocardial ischemia. After that, an on-pump beating heart coronary artery bypass grafting (CABG) was performed 2 days later due to the high risk of bleeding related to the recent cesarean section operation. The LAD and diagonal artery were anastomosed with the left internal thoracic artery and saphenous vein grafts. She was discharged from the intensive care unit on postoperative day 2 and discharged from the hospital on day 8. P-SCAD is an important condition that can occur especially at a young age, its diagnosis may be overlooked, but it can cause serious clinical consequences. The treatment strategy should be decided in a multidisciplinary manner and should be individualized for each patient. This diagnosis should be kept in mind, especially when a young pregnant patient without cardiovascular risk factors presents with myocardial infarction findings.

Acute generalized exanthematous pustulosis (AGEP) is a rare drug eruption characterized by the rapid occurrence of many sterile, non-follicular pustules, neutrophilic leukocytosis, high fever and spontaneous resolution usually within two weeks. The distribution of rash predilection in the trunk and intertriginous regions. In treatment, the causative drug must be initially discontinued. Topical corticosteroids, moisturizers, antipyretics, and systemic corticosteroids are generally used according to the patient’s symptoms and AGEP severity. Cyclosporine and intravenous immunoglobulin therapy can be used in some patients with AGEP resistant to systemic corticosteroids in severe AGEP. We herein aim to report a unique case of AGEP that has different rash distribution and resistance to systemic corticosteroids.

Chromosome 15q26 deletion is a rare condition that causes short stature and is associated with intrauterine growth restriction (IUGR), failure to thrive, congenital heart disease and many congenital malformations. The insulin growth factor receptor (IGF-1R) on chromosome 15 has many important roles, especially in growth regulation. Our case is an 18-month-old small for gestational age girl who presented with severe short stature, microcephaly and minor dysmorphic features. Chromosome microarray revealed 15q26 deletion including the IGF1R gene. Recombinant growth hormone (rGH) has been used in patients with IGF-1R defects with variable treatment responses. The reason for rGH unresponsiveness in some patients with terminal chromosome 15q deletion is still unclear. Herein we discuss the use of rGH in a patient with heterozygous IGF1R deletion and emphasize the need for further follow-up regarding other endocrine disorders.