Uterin Kama Rezeksiyonu ile Tedavi Edilen Overin Seks Kord Tümörüne Benzeyen Uterin Tümör Vakası

Abstract

Amaç: Amaç: Overin seks kord tümörüne benzeyen uterin tümör (OSKTBUT) nadir görülen bir uterus tümörüdür. Patolojik olarak daha agresif seyreden ve sağ kalımı daha kötü olan seks kord elemanları olan endometrial stromal tümörlerden ayrılmalıdır. Histerektomi ± ooferektomi tercih edilen tedavi şekli olsa da son yıllarda genç hastalarda fertilite koruyucu cerrahi uygulanmaya başlanmıştır. Tümörün histeroskopik rezeksiyonu en sık uygulanan yaklaşımdır. Bildiğimiz kadarıyla bu olgu uterin kama rezeksiyonu ile tedavi edilen ilk OSKTBUT vakasıdır. Olgu: 26 yaşında, nulligravid, menometroraji şikayeti ile başvuran hastada 4 cm submüköz myom tespit edilmiştir. Abdominal myomektomi yapılan hastanın patoloji sonucu OSKTBUT olarak raporlanmıştır. Kontrol ultrasonografi ve PET/BT’sinde uterusta şüpheli lezyon saptanan hastaya uterin kama rexeksiyonu yapılmış ve temiz cerrahi sınır elde edilmiştir. Hasta 6 yıldır hastalıksız takip edilmektedir. Tartışma: OSKTBUT genelde ileri yaşta görülmektedir. Tümörün düşük malignite potansiyeli olduğundan genç, fertilite isteği olan hastalarda uterus koruyucu cerrahi uygulanabilmektedir. Fertilite koruyucu yaklaşımların güvenilirliğini ve sonuçlarını desteklemek için daha fazla vakaya ihtiyaç vardır.

Keywords

• Overin seks kord tümörüne benzeyen uterin tümör,fertilite koruyucu cerrahi

A Case of Uterine Tumor Resembling Ovarian Sex Cord Tumor Treated with Uterine Wedge Resection

Abstract

Introduction: Uterine tumor resembling ovarian sex cord tumors (UTROSCT) are infrequent forms of uterine tumors. It should be distinguished from endometrial stromal tumors with sex cord like elements (ESTSCLE) since the latter one is more aggressive and the outcome is poorer. Hysterectomy with or without adnexectomy is the preferred choice of treatment. Fertility preserving treatment options are seen more commonly in the last decade for young patients. Hysteroscopic resection of the tumor is the most frequent approach. To our knowledge this is the fi rst case of UTROSCT who was treated with uterine wedge resection. Case: We describe here a case of 26-year-old nulligravid woman with menometrorrhagia whose ultrasonographic examination revealed 4 cm submucous myoma. Abdominal myomectomy was done but the pathological result was UTROSCT. An abnormal lesion was detected in her control ultrasonography and PET/CT. She then underwent uterine wedge resection with clear surgical margins. She is being followed up for 6 years with no evidence of disease. Discussion: UTROSCT is usually seen in elderly women. Conservative management can be an option for younger women who have fertility desire. It seems like it is an acceptable choice since the tumor has low malignant potential. More cases are needed to support the safety of fertility preserving treatment and the outcome. 

Keywords

• Uterine tumors resembling ovarian sex cord tumors,fertility preservation

References

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