Abstract
Amaç: Nadir görülen bir nongestasyonel ovaryen koryokarsinom vakasının sunulması.Olgu Sunumu: 50 yaşındaki F.Y 1 aydır devam eden aşırı vaginal kanama, kasık ağrısı, iştahsızlık ve kilo kaybı şikayeti ile Kadın Hastalıkları ve Doğum Kliniğine başvurdu. Hastanın anamnezinden hipertiroidi nedeniyle medikal tedavi aldığı öğrenildi. Hastanın yapılan pelvik muayenesinde uterustan net ayrılamayan sol adneksiyal alanda solid kıvamlı, semifikse pelvik kitlesinin olduğu saptandı. Hastanın pelvik ultrasonografisinde ise sol adneksiyel alanda 6.5x8 cm ebadında solid iç ekolu dejenerasyonlar gösteren heterojen kitle izlendi. Laboratuvar bulgularından β-hCG>200.000 mIU/mL, AFP: 4.8 IU/mL (0-7), CEA: 4.0 ug/mL (0-4.1), CA125 13 U/mL(0-21), CA 19.9 26.1 U/mL (0-18.4), CA15.3 45.5 U/mL(7.5-53), Serbest T3 6.30pg/mL (1.8-4.2), Serbest T4 2.72ng/dL (0.8-1.76), TSH 0.015 IU/mL (0.24-3.58) olarak bulundu.Postero-anterior akciğer grafisi, batın ultrasonografisi, toraks ve beyin tomografileri normal olan hasta koryokarsinom ön tanısıyla operasyona alındı. Laparotomide sol paraovarian bölgede 6x8 cmlik frajil etrafa yapışık kitle izlendi. Hastaya Total Abdominal Histerektomi+bilateral salpingoooferektomi, lenfadenektomi omentektomi ve sitolojik inceleme için örnek alındı. Operasyon sonrası kitlenin histopatolojik incelemesi non-gestasyonel ovaryen koryokarsinom Evre Ic olarak değerlendirildi. Sitolojik incelemede malign hücreler tesbit edildi. Postoperatif dönemde serum β-hCG değeri 71.8 mIU/mL gelen hastaya 4 kür Bleomisin Etoposid, Cisplatin (BEP) kemoterapisi verildi.Sonuç: Nongestasyonel ovaryen koryokarsinom vakaları Bleomisin Etoposid, Cisplatin (BEP) kemoterapisi ile başarılı bir şekilde tedavi edilebilir.
Abstract
Aim: To demonstrate a case with rarely seen nongestational ovarian choriocarcinoma. Case Report: 50 year old F.Y. admitted to obstetric and gynecologic department with vaginal bleeding for about one month, inguinal cramps, weight loss and loss of appetite complaints. In her anamnesis it was learnt that she had medical treatment for hyperthyroidism. In pelvic examination of the patient a solid, semifixed, pelvic mass was palpated which was located in the left adnexial area and which could not be differentiated from the uterus. In pelvic ultrasonography of the patient a heterogeneous mass with degenerative, solid components in left adnexial area with 6,5x8 cm dimensions was observed. Laboratory findings were β- hCG>200.000 mIU/mL, AFP: 4.8 IU/mL (0-7), CEA: 4.0 ug/mL (0-4.1), CA125 13 U/mL(0-21), CA 19.9 26.1 U/mL (0-18.4), CA15.3 45.5 U/mL(7.5-53), Free T3 6.30pg/mL (1.8-4.2), Free T4 2.72ng/dL (0.8-1.76), TSH 0.015 IU/mL (0.24-3.58).Anteroposterior lung graphy, abdominal ultrasonography, thorax and brain tomographies were found to be normal. Patient was operated with the diagnosis of choriocarcinoma. In laparotomy, a 6x8 cm fragile mass adherent to adjacent tissues in left paraovarian area was seen.Total abdominal hysterectomy-bilateral salpingooopherectomy, lymphadenectomy, omentectomy was done; also sample for cytological examination was taken. In postoperative period, evaluated as nongestational ovarian choriocarcinoma stage Ic. Malign cells were detected in cytologic examination. Postoperative β-hCG level of the patient was found to be 71.8 mIU/mL and 4 doses of BEP chemotherapy was applied to the patient. Conclusion: The cases with nongestational ovarian choriocarcinoma can be treated with BEP chemotherapy succesfully.
Details
| Other ID | JA92EU73MV |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | July 1, 2004 |
| Submission Date | July 1, 2004 |
| Published in Issue | Year 2004 Volume: 7 Issue: 3 |