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Overin Primer ve Metastatik Müsinöz Tümörlerine Algoritmik Yaklaşım

Year 2019, Volume: 5 Issue: 2, 176 - 180, 01.01.2019

Abstract

Amaç: Bu çalışmanın amacı overin primer ve metastatik müsinöz tümörlerinde ayırıcı tanıda histopatolojik özelliklere ek olarak immünohistokimyasal bulgular, tümör boyutu ve lateralitenin primer – metastaz ayırımındaki tanısal değerini araştırmaktır. Gereç ve Yöntemler: Hastanemizde 2001-2012 yılları arasında tanı alan 222 müsinöz over tümörü olguları patoloji arşivinden retrospektif olarak tarandı. Olgular yaş, lateralizasyon, tümör boyutu ve immünohistokimyasal olarak değerlendirildi. Bulgular: Çalışmaya dahil edilen 222 olgunun 195’i primer müsinöz over tümörü, 27’si metastatik müsinöz tümör tanısı almış idi. Primer olguların kendi içinde dağılımları sırası ile kistadenomlar 135/195, müsinöz karsinomlar 31/195 ve borderline tümörler 29/195 idi. Olguların yaş ortalaması 48,7 14y-72y idi. Lateraliteye bakıldığında borderline tümörlerin 29/29 ve müsinöz karsinomların 27/31 tek overde görülme oranları daha yüksek iken metastatik tümörlerde bu oran daha düşük idi 11/27 . Tümör boyutları değerlendirildiğinde primer tümörlerde boyutun daha yüksek olduğu metastatik lezyonlarda tümör boyutunun daha düşük olduğu tespit edildi. Sonuç: Müsinöz tümörler, over tümörleri içerisinde metastaz ve primer ayırımının yapılması gereken önemli bir gruptur. Metastatik tümörlerin büyük bir kısmı primer over tümörünü taklit ederler ancak metastaz-primer ayırımında tümör boyutu ve lateralitenin önemli bir veri olduğunu bunun yanında immünohistokimyanın da tanısal doğruluğu artırmada yararlı olacağını düşünmekteyiz

References

  • Park CK, Kim HS. Clinicopathological characteristics of ovarian metastasis from colorectal and pancreatobiliary carcinomas mimicking primary ovarian mucinous tumor. Anticancer Res 2018; 38(9):5465-73.
  • Kubeček O, Laco J, Špaček J, Petera J, Kopecký J, Kubečková A, Filip S. The pathogenesis, diagnosis, and management of metastatic tumors to the ovary: A comprehensive review. Clin Exp Metastasis 2017; 34(5):295-307.
  • incidence in routine practice with a new approach to
  • improve intraoperative diagnosis. Am J Surg Pathol 2003; 27(7):985-93.
  • McCluggage WG. Immunohistochemistry in the distinction between primary and metastatic ovarian mucinous neoplasms. J Clin Pathol 2012; 65(7):596-600.
  • Ates Ozdemir D, Usubutun A. PAX2, PAX8 and CDX2 expression in metastatic mucinous, primary ovarian mucinous and seromucinous tumors and review of the literature. Pathol Oncol Res 2016; 22(3):593-9.
  • Lagendijk JH, Mullink H, Van Diest PJ, Meijer GA, Meijer CJ. Tracing the origin of adenocarcinomas with unknown primary using immunohistochemistry: Differential diagnosis between colonic and ovarian carcinomas as primary sites. Hum Pathol 1998; 29(5):491-7.
  • Chu PG, Chung L,Weiss LM, Lau SK. Determining the site of origin of mucinous adenocarcinoma: An immunohistochemical study of 175 cases. Am J Surg Pathol 2011; 35(12):1830-6.
  • Schmoeckel E, Kirchner T, Mayr D. SATB2 is a supportive marker for the differentiation of a primary mucinous tumor of the ovary and an ovarian metastasis of a low-grade appendiceal mucinous neoplasm (LAMN): A series of seven cases. Pathol Res Pract 2018; 214(3):426- 30.
  • Strickland JK, Wasserman A, Giassi B, Djordjevic C. Parra-Herran, immunohistochemistry in the diagnosis of mucinous neoplasms involving the ovary: the added value of SATB2 and biomarker discovery through protein expression database mining. Int J Gynecol Pathol 2016; 35(3):191-208.
  • Kurman RJ, Carcangiu ML, Herrington CS, Young RH. WHO classification of tumours of female reproductive organs. 4th ed. Geneva: IARC, 2014.

Algorithmic Approach to Primary and Metastatic Mucinous Ovarian Tumors

Year 2019, Volume: 5 Issue: 2, 176 - 180, 01.01.2019

Abstract

Objective: The aim of this study was to investigate the importance of immunohistochemical findings and tumor size and laterality in addition to the histopathological features in the diagnosis of primary and metastatic mucinous tumors of the ovary.Material and Methods: Two hundred and twenty two mucinous ovarian tumors diagnosed between 2001 and 2012 were retrospectively reviewed in our hospital pathology archive. The cases were evaluated for age, lateralization, tumor size and immunohistochemistry.Results: Of the 222 cases included in the study, 195 were diagnosed as primary mucinous tumor and 27 as metastatic mucinous tumor. The distribution of the primary cases was cystadenomas in 135/195, mucinous carcinomas in 31/195 and borderline tumors in 29/195 cases. The mean age of the patients was 48.7 years range 14y-72y . When laterality was evaluated, borderline tumors 29/29 and mucinous carcinomas 27/31 had a higher incidence in a single ovary but this rate was lower in metastatic tumors 13/27 . When tumor size was evaluated, it was found that tumor size was lower in metastatic lesions while the size of the primary tumors was larger.Conclusion: Mucinous tumors are an important group where the differentiation of metastasis and primary lesion should be performed. Most of the metastatic tumors mimic the primary ovarian tumor, but we think that tumor size and laterality are important for the differentiation between metastasis and primary while immunohistochemistry may be useful in increasing the diagnostic accuracy

References

  • Park CK, Kim HS. Clinicopathological characteristics of ovarian metastasis from colorectal and pancreatobiliary carcinomas mimicking primary ovarian mucinous tumor. Anticancer Res 2018; 38(9):5465-73.
  • Kubeček O, Laco J, Špaček J, Petera J, Kopecký J, Kubečková A, Filip S. The pathogenesis, diagnosis, and management of metastatic tumors to the ovary: A comprehensive review. Clin Exp Metastasis 2017; 34(5):295-307.
  • incidence in routine practice with a new approach to
  • improve intraoperative diagnosis. Am J Surg Pathol 2003; 27(7):985-93.
  • McCluggage WG. Immunohistochemistry in the distinction between primary and metastatic ovarian mucinous neoplasms. J Clin Pathol 2012; 65(7):596-600.
  • Ates Ozdemir D, Usubutun A. PAX2, PAX8 and CDX2 expression in metastatic mucinous, primary ovarian mucinous and seromucinous tumors and review of the literature. Pathol Oncol Res 2016; 22(3):593-9.
  • Lagendijk JH, Mullink H, Van Diest PJ, Meijer GA, Meijer CJ. Tracing the origin of adenocarcinomas with unknown primary using immunohistochemistry: Differential diagnosis between colonic and ovarian carcinomas as primary sites. Hum Pathol 1998; 29(5):491-7.
  • Chu PG, Chung L,Weiss LM, Lau SK. Determining the site of origin of mucinous adenocarcinoma: An immunohistochemical study of 175 cases. Am J Surg Pathol 2011; 35(12):1830-6.
  • Schmoeckel E, Kirchner T, Mayr D. SATB2 is a supportive marker for the differentiation of a primary mucinous tumor of the ovary and an ovarian metastasis of a low-grade appendiceal mucinous neoplasm (LAMN): A series of seven cases. Pathol Res Pract 2018; 214(3):426- 30.
  • Strickland JK, Wasserman A, Giassi B, Djordjevic C. Parra-Herran, immunohistochemistry in the diagnosis of mucinous neoplasms involving the ovary: the added value of SATB2 and biomarker discovery through protein expression database mining. Int J Gynecol Pathol 2016; 35(3):191-208.
  • Kurman RJ, Carcangiu ML, Herrington CS, Young RH. WHO classification of tumours of female reproductive organs. 4th ed. Geneva: IARC, 2014.
There are 11 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Emine Kılıç Bağır This is me

Arbil Açıkalın This is me

Ümran Küçükgöz Güleç This is me

A. Barış Güzel This is me

M. Ali Vardar This is me

Derya Gümürdülü This is me

Publication Date January 1, 2019
Published in Issue Year 2019 Volume: 5 Issue: 2

Cite

Vancouver Kılıç Bağır E, Açıkalın A, Küçükgöz Güleç Ü, Güzel AB, Vardar MA, Gümürdülü D. Overin Primer ve Metastatik Müsinöz Tümörlerine Algoritmik Yaklaşım. Akd Med J. 2019;5(2):176-80.