Apendektomi sonrası tesadüfen teşhis edilen tubal yüksek dereceli seröz karsinom olgu sunumu

Year 2023, Volume: 16 Issue: 3, 510 - 514, 01.07.2023

Pelin Höbek , M.anıl Onan

https://doi.org/10.31362/patd.1232920

Abstract

Tubanın primer karsinomları kadın genital sisteminde nadir görülen tümörlerdir ve klinik olarak primer over karsinomlarına benzerler. Belirsiz semptomları nedeniyle sıklıkla ileri evrede tanı alırlar ve preoperatif tanı koymak zordur. En önemli tedavi basamağı optimal sitoredüksiyonun sağlanmasıdır.
Bu olgu sunumunda apendektomi sonrası tesadüfen saptanan high grade seröz tubal karsinom olarak raporlanan olguya yönelik klinik ve cerrahi yaklaşımımızdan bahsedilmektedir. 65 yaşında postmenopozal hasta (gravida 4, parite 3) akut karın semptomları ile başka bir merkeze başvurdu. Apandisit ön tanısı ile hastaya apendektomi yapıldı ve apendektomi spesmeninin nihai patoloji sonucu seröz karsinom infiltrasyonu olarak raporladı. Hastaya seröz karsinom endikasyonu ile evreleme cerrahisi yapıldı. Appendektomi materyali ile tesadüfen saptanan ve high grade tubal seröz karsinom olarak bildirilen olguya klinik ve cerrahi yaklaşımımız vaka çalışması olarak sunulmaktadır.

Keywords

Ovaryum ve tubauterina hastalıkları, apendiks neoplazileri, tümör metastazı

Supporting Institution

Gazi Üniversitesi Tıp Fakültesi

A case report of tubal high grade serous carcinoma, which was diagnosed incidentally after appendectomy

Abstract

Primary tubal carcinoma is an uncommon tumor of female genitale system. The clinical approach of primary tubal cancers is similar to primary ovarian cancers. Fallopian tube carcinoma is hard to diagnosed preoperatively because of its indistinct symptoms. Optimal cytoreductive surgery is the most important treatment step in ovarian, tubal and peritoneal carcinomas.
We report a case of serous tubal intraepithelial carcinoma with appendix metastasis. A 65 years old post-menopausal woman (gravida 4, para 3) submitted to an external hospital with lower abdominal pain and acute abdominal symptoms. Appendectomy was performed on the patient with preliminary diagnosis of apendicitis. The pathology result was reported as high grade serous carcinoma infiltration. Staging surgery was performed with the diagnosis of carcinoma. Until the final pathology result, the diagnosis was considered as appendiceal metastasis of serous tubal cancer. Our clinical and surgical approach to the case, which was diagnosed incidentally with an appendectomy specimen and reported as high grade tubal serous carcinoma, is presented as a case study.

Keywords

Adnexal diseases, appendiceal neoplasms, neoplasm metastasis

References

• 1. Alhadid D, AlShammari A, Almana H, Aburahmah M. Missed gastric cancer metastasis to the appendix. Am J Case Rep 2020;21:e920010. https://doi.org/10.12659/ ajcr.920010
• 2. Leonards LM, Pahwa A, Patel MK, Petersen J, Nguyen MJ, Jude CM. Neoplasms of the appendix: pictorial review with clinical and pathologic correlation. RadioGraphics 2017;37:1059-1083. https://doi. org/10.1148/rg.2017160150
• 3. Stasenko M, Fillipova O, Tew WP. Fallopian tube carcinoma. J Oncol Pract 2019;15:375-383. https://doi. org/10.1200/jop.18.00662
• 4. Gomes FV, Dias JL, Lucas R, Cunha TM. Primary fallopian tube carcinoma: review of MR imaging findings. Insights Imaging 2015;6:431-439. https://doi. org/10.1007/s13244-015-0416-y
• 5. Berek JS, Renz M, Kehoe S, Kumar L, Friedlander M. Cancer of the ovary, fallopian tube, and peritoneum: 2021 update. Int J Gynecol Obstet 2021;155:61-85. https://doi.org/10.1002/ijgo.13878
• 6. Howitt BE, Hanamornroongruang S, Lin DI, et al. Evidence for a dualistic model of high-grade serous carcinoma: BRCA mutation status, histology, and tubal intraepithelial carcinoma. Am J Surg Pathol 2015;39:287-293. https://doi.org/10.1097/ pas.0000000000000369
• 7. Quartuccio SM, Karthikeyan S, Eddie SL, et al. Mutant p53 expression in fallopian tube epithelium drives cell migration. Int J Cancer 2015;137:1528-1538. https:// doi.org/10.1002/ijc.29528
• 8. Adler E, Mhawech Fauceglia P, Gayther SA, Lawrenson K. PAX8 expression in ovarian surface epithelial cells. Hum Pathol 2015;46:948-956. https:// doi.org/10.1016/j.humpath.2015.03.017
• 9. Timmermans M, Sonke GS, Van de Vijver KK, van der Aa MA, Kruitwagen RFPM. No improvement in longterm survival for epithelial ovarian cancer patients: a population-based study between 1989 and 2014 in the Netherlands. Eur J Cancer 2018;88:31-37. https://doi. org/10.1016/j.ejca.2017.10.030
• 10. Hariprasad P, Hariprasad S, Srinivas T, Shetty KJJ. Primary bilateral fallopian tube carcinoma the report of a single case with review of the literature. J Clin Diagn Res 2013;7:930-932. https://doi.org/10.7860/ jcdr/2013/5483.2980
• 11. Ataseven B, Grimm C, Harter P, et al. Prognostic impact of debulking surgery and residual tumor in patients with epithelial ovarian cancer FIGO stage IV. Gynecol Oncol 2016;140:215-220. https://doi.org/10.1016/j. ygyno.2015.12.007
• 12. Rai S, Maheshwari A. Management of fallopian tube cancer. Rev Recent Clin Trials 2015;10:276-281. https://doi.org/10.2174/1574887110666150923112556
• 13. Yoon WJ, Yoon YB, Kim YJ, Ryu JK, Kim YT. Secondary appendiceal tumors: a review of 139 cases. Gut Liver 2010;4:351-356. https://doi.org/10.5009/ gnl.2010.4.3.351
• 14. Koo YJ, Im KS, Kwon YS, et al. Primary fallopian tube carcinoma: a clinicopathological analysis of a rare entity. Int J Clin Oncol 2011;16:45-49. https://doi. org/10.1007/s10147-010-0128-8
• 15. Sun M, Bao L, Shen H, et al. Unexpected primary fallopian tube carcinoma during gynecological operations: clinicopathological and prognostic factors analyses of 67 cases. Taiwan J Obstet Gynecol 2019;58:626-632. https://doi.org/10.1016/j. tjog.2019.07.008
• 16. Bao L, Ding Y, Cai Q, et al. Primary fallopian tube carcinoma: a single–ınstitution experience of 101 cases: a retrospective study. Int J Gynecol Cancer 2016;26:424-430. https://doi.org/10.1097/ igc.0000000000000648