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Unusual Causes of Adnexal Masses in Early Reproductive Period

Year 2012, Volume: 4 Issue: 1, 43 - 46, 01.04.2012

Abstract

Ovarian tumors when detected in the reproductive period are challenging. We present three different cases diagnosed as an immature teratoma IT of ovary, a primary peritoneal serous papillary carcinoma PSPC and a metastatic ovarian diffuse large B-cell Lymphoma in the early reproductive period. IT of the ovary is an uncommon tumor; predominantly solid with increased serum alphafetoprotein levels may be associated with a greater likelihood. PSPC should be suggested as a diagnosis in patients with extensive peritoneal carcinomatosis, relatively normal sized ovaries, and a highly elevated serum CA-125 level. Lymphomas on CT may appear solid, include singular enlarged lymph nodes and fusion of multiple enlarges nodes. As lymphomas have fastest doubling time the radiologic evaluation may progress in few days and may be a clue for the diagnosis. Especially, ovarian cysts with nodal masses suggest a lymphoma with ovarian metastasis.

References

  • 1. Ferlay J, Bray F, Pisani P, Parkin DM. GLOBOCAN 2002: Cancer Incidence. Mortality and Prevalence Worldwide. IARC CancerBase No. 5, version 2.0., Lyon: IARC Press 2004
  • 2. Di Saia P, Cresman WT. Clinical gynaecological oncology. USA: Mosby; 1997. p. 351–74.
  • 3. Colomboa N, Gorp T.V, Parma G, Amant F, Gatta G, Sessa C,et al. Ovarian cancer Crit Rev Oncol Hematol 2006;60:159–179
  • 4. Talerman A. Germ cell tumors of the ovary. In: Kurman RJ editor. Blaustein’s Pathology of the female genital tract. 5th ed. Springer. p.994
  • 5. Sabaa L, Guerrierod S, Sulcis R, Virgilio B, Melis GB, Mallarinia G. Mature and immature ovarian teratomas: CT, US and MR imaging characteristics Eur J Radiol 2009;72:454–463
  • 6. Çilesiz G.P, Çetin A, Tarlacı A, Ton Ö. Immature ovarian teratoma presenting with abnormal uterine bleeding. Turkiye Klinikleri J Gynecol Obst 2007;17:334-6
  • 7. Clement PB. Diseases of the peritoneum. In: Kurman RJ editor. Blaustein’s Pathology of the female genital tract. 5th ed. Springer. p.771
  • 8. Bell DA, Scully RE. Serous borderline tumors of the peritoneum. Am J Surg Pathol 1990; 14:230-239.
  • 9. Bloss JD, Liao SY, Buller RE, Manetta A, Berman ML, McMeekin S, et al. Extraovarian peritoneal serous papillary carcinoma: a case-control retrospective comparison to papillary adenocarcinoma of the ovary. Gynecol Oncol. 1993;50:347–351.
  • 10. Stafford-Johnson DB, Bree RL, Francis IR, Korobkin M. CT appearance of primary papillary serous carcinoma of the peritoneum. AJR 1998;171:687–689
  • 11. Chopra S, Laurie LR, Chintapalli KN, Valente PT, Dodd GD III. Primary serous carcinoma of the peritoneum: CT-pathologic correlation. J Comput Assist Tomogr 2000;24:395–399
  • 12. Altaras MM, Aviram R, Cohen I, Cordoba M, Weiss E, Beyth Y. Primary peritoneal papillary serous adenocarcinoma: clinical and management aspects. Gynecol Oncol. 1991;40:230-236
  • 13. Karlan BY, Baldwin RL, Lopez-Luevanos E, Raffel LJ, Barbuto D, Narod S, et al. Peritoneal serous papillary carcinoma, a phenotypic variant of familial ovarian cancer: implications for ovarian cancer screening. Am J Obstet Gynecol. 1999;180:917-928.
  • 14. Fox H, Langley FA, Govan AD, Hill AS, Bennett MH. Malignant lymphoma presenting as an ovarian tumour: a clinicopathological analysis of 34 cases. Br J Obstet Gynaecol 1988 Apr; 95(4):386-390
  • 15. Elharroudi T, Ismaili N, Errihani H, Jalil A. Primary lymphoma of the ovary. J Can Res Ther 2008;4:195- 196.
  • 16. Crawshaw J, Sohaib AS, Wotherspoon A, Shepherd JH. Primary non-Hodgkin’s Lymphoma of the ovaries: imaging findings. Br J Radiol 2007;80:155-157.
  • 17. Vang R, Medeiros LJ, Warnke RA, Higgins JP. Deavers MT. Ovarian non-Hodgkin’s lymphoma: A clinicopathologic study of eight primary cases. Mod Pathol 2001; 14(11):1093-1099.
  • 18. d’Amore F, de Nully Brown P, Weisenberger D. Epidemiology of extranodal lymphomas. In: Cavalli F, Stein H, Zucca E, eds. Extranodal lymphomas, pathology and management. London: Informa Healthcare, 2008: 14-23.
  • 19. Wu N, Liu Y, Lin D, Chen Y, Shi M. Abdominal and pelvic lymph nodes in non-Hodgkin lymphoma: the nodal distribution in Chinese patients. Zhonghua Zhongliu Zazhi 2002; 24: 580-584
  • 20. Yu R.S, Zhang W.M, Liu Y.Q. CT diagnosis of 52 patients with lymphoma in abdominal lymph nodes World J Gastroenterol 2006;28; 12(48): 7869-7873
  • 21. Dilek S, Ergün A, Ülgenalp I, Orhon E, Rabuçcu R. Extranodal primary ovarian lymphoma. Turkiye Klinikleri J Gynecol Obst 1994;4:197-199
  • 22. Ferrozzi F, Tognini G, Bova D, Zuccoli G. NonHodgkin’s lymphomas of the ovaries: MR findings. J Comput Assist Tomogr 2000;24:416–420.

Erken Üreme Çağında Adneksial Kitlelerin Nadir Sebepleri

Year 2012, Volume: 4 Issue: 1, 43 - 46, 01.04.2012

Abstract

Üreme çağında tespit edilen ovaryan tümörler akıl karıştırıcıdır. Bu yazıda üç ayrı tanılı vaka sunuyoruz; Overin immature teratomu IT , overin primer peritoneal seröz papiler karsinomu PSPC ve metastatik ovaryan diffuz büyük B-hücreli Lenfoması. Overe ait IT sıklıkla solid, artmış alfafetoprotein değerleriyle birlikte görünen nadir bir tümördür. PSPC, normal büyüklükte overler, yaygın peritoneal karsinomatosis ve belirgin artmış CA12-5 değerleriyle birlikte olan hastalarda tanıda düşünülmesi gerekir. Lenfoma, CT'de çok sayıda büyümüş nodların füzyonu veya tek oldukça genislemiş lenf nodlarını içeren solid kitleler olarak karşımıza çıkar. Lenfomalar en hızlı doubling zamanına sahip olduğundan radyolojik inceleme birkaç günde ilerleme gösterebilir ki bu bir ipucu olabilir. Özellikle nodal kitleler ile birlikte ovaryan kistler ovaryan metastazı olan lenfomayı düşündürür.

References

  • 1. Ferlay J, Bray F, Pisani P, Parkin DM. GLOBOCAN 2002: Cancer Incidence. Mortality and Prevalence Worldwide. IARC CancerBase No. 5, version 2.0., Lyon: IARC Press 2004
  • 2. Di Saia P, Cresman WT. Clinical gynaecological oncology. USA: Mosby; 1997. p. 351–74.
  • 3. Colomboa N, Gorp T.V, Parma G, Amant F, Gatta G, Sessa C,et al. Ovarian cancer Crit Rev Oncol Hematol 2006;60:159–179
  • 4. Talerman A. Germ cell tumors of the ovary. In: Kurman RJ editor. Blaustein’s Pathology of the female genital tract. 5th ed. Springer. p.994
  • 5. Sabaa L, Guerrierod S, Sulcis R, Virgilio B, Melis GB, Mallarinia G. Mature and immature ovarian teratomas: CT, US and MR imaging characteristics Eur J Radiol 2009;72:454–463
  • 6. Çilesiz G.P, Çetin A, Tarlacı A, Ton Ö. Immature ovarian teratoma presenting with abnormal uterine bleeding. Turkiye Klinikleri J Gynecol Obst 2007;17:334-6
  • 7. Clement PB. Diseases of the peritoneum. In: Kurman RJ editor. Blaustein’s Pathology of the female genital tract. 5th ed. Springer. p.771
  • 8. Bell DA, Scully RE. Serous borderline tumors of the peritoneum. Am J Surg Pathol 1990; 14:230-239.
  • 9. Bloss JD, Liao SY, Buller RE, Manetta A, Berman ML, McMeekin S, et al. Extraovarian peritoneal serous papillary carcinoma: a case-control retrospective comparison to papillary adenocarcinoma of the ovary. Gynecol Oncol. 1993;50:347–351.
  • 10. Stafford-Johnson DB, Bree RL, Francis IR, Korobkin M. CT appearance of primary papillary serous carcinoma of the peritoneum. AJR 1998;171:687–689
  • 11. Chopra S, Laurie LR, Chintapalli KN, Valente PT, Dodd GD III. Primary serous carcinoma of the peritoneum: CT-pathologic correlation. J Comput Assist Tomogr 2000;24:395–399
  • 12. Altaras MM, Aviram R, Cohen I, Cordoba M, Weiss E, Beyth Y. Primary peritoneal papillary serous adenocarcinoma: clinical and management aspects. Gynecol Oncol. 1991;40:230-236
  • 13. Karlan BY, Baldwin RL, Lopez-Luevanos E, Raffel LJ, Barbuto D, Narod S, et al. Peritoneal serous papillary carcinoma, a phenotypic variant of familial ovarian cancer: implications for ovarian cancer screening. Am J Obstet Gynecol. 1999;180:917-928.
  • 14. Fox H, Langley FA, Govan AD, Hill AS, Bennett MH. Malignant lymphoma presenting as an ovarian tumour: a clinicopathological analysis of 34 cases. Br J Obstet Gynaecol 1988 Apr; 95(4):386-390
  • 15. Elharroudi T, Ismaili N, Errihani H, Jalil A. Primary lymphoma of the ovary. J Can Res Ther 2008;4:195- 196.
  • 16. Crawshaw J, Sohaib AS, Wotherspoon A, Shepherd JH. Primary non-Hodgkin’s Lymphoma of the ovaries: imaging findings. Br J Radiol 2007;80:155-157.
  • 17. Vang R, Medeiros LJ, Warnke RA, Higgins JP. Deavers MT. Ovarian non-Hodgkin’s lymphoma: A clinicopathologic study of eight primary cases. Mod Pathol 2001; 14(11):1093-1099.
  • 18. d’Amore F, de Nully Brown P, Weisenberger D. Epidemiology of extranodal lymphomas. In: Cavalli F, Stein H, Zucca E, eds. Extranodal lymphomas, pathology and management. London: Informa Healthcare, 2008: 14-23.
  • 19. Wu N, Liu Y, Lin D, Chen Y, Shi M. Abdominal and pelvic lymph nodes in non-Hodgkin lymphoma: the nodal distribution in Chinese patients. Zhonghua Zhongliu Zazhi 2002; 24: 580-584
  • 20. Yu R.S, Zhang W.M, Liu Y.Q. CT diagnosis of 52 patients with lymphoma in abdominal lymph nodes World J Gastroenterol 2006;28; 12(48): 7869-7873
  • 21. Dilek S, Ergün A, Ülgenalp I, Orhon E, Rabuçcu R. Extranodal primary ovarian lymphoma. Turkiye Klinikleri J Gynecol Obst 1994;4:197-199
  • 22. Ferrozzi F, Tognini G, Bova D, Zuccoli G. NonHodgkin’s lymphomas of the ovaries: MR findings. J Comput Assist Tomogr 2000;24:416–420.
There are 22 citations in total.

Details

Primary Language Turkish
Journal Section Case Report
Authors

Erdin Ilter This is me

Neşe Yener This is me

Aygen Celik This is me

Tonguç Gündüz This is me

Erdal Yücel This is me

Berna Haliloğlu This is me

Ahmet Midi This is me

Umit Ozekici This is me

Publication Date April 1, 2012
Published in Issue Year 2012 Volume: 4 Issue: 1

Cite

Vancouver Ilter E, Yener N, Celik A, Gündüz T, Yücel E, Haliloğlu B, Midi A, Ozekici U. Erken Üreme Çağında Adneksial Kitlelerin Nadir Sebepleri. Maltepe tıp derg. 2012;4(1):43-6.