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.
References
- 1. Clement PB, Scully RE. Uterine tumors resembling ovarian sex cord tumors. A clinicopathologic analysis of fourteen cases. Am J Clin Pathol 1976;66:512.
- 2. Schraag SM, Caduff R, Dedes KJ, Fink D, Schmidt AM. Uterine tumors resembling ovarian sex cord tumors – treatment, recurrence, pregnancy and brief review. Gynecol Oncol Rep 2017;19:53-56.
- 3. Jeong KH, Lee HN, Kim MK, Kim ML, Seong SJ, Shin E. Successful delivery after conservative resectoscopic surgery in a patient with a uterine tumor resembling ovarian sex cord tumor with myometrial invasion. Obstet Gynecol Sci 2015;58(5):418-422.
- 4. Blake EA, Sheridan TB, Wang KL, et al. Clinical characteristics and outcomes of uterine tumors resembling ovarian sex-cord tumors (UTROSCT): a systematic review of literature. Eur J Obstet Gynecol Reprod Biol 2014;181C:163-170.
- 5. De Franciscis P, Grauso F, Ambrosio D, Torella M, Messalli EM, Colacurci N. Conservative resectoscopic surgery, successful delivery, and 60 months of follow-up in a patient with endometrial stromal tumor with sex-cordlike differentiation. Case Rep Obstet Gynecol 5736865.
- 6. Liu CY, Shen Y, Zhao JG, Qu PP. Clinical experience of uterine tumors resembling ovarian sex cord tumors: a clinicopathological analysis of 6 cases. Int J Clin Exp Pathol 2015;8(4):4158-4164.
- 7. Endo D, Todo Y, Okamoto K, Suzuki H. A case of recurrent group II uterine tumor resembling ovarian sex-cord tumors, against which two hormonal agents were ineffective. Taiwan J Obstet Gynecol 2016 Oct;55(5):751-3.
- 8. Pradhan D, Mohanty SK. Uterine tumors resembling ovarian sex cord tumors. Arch Pathol Lab Med 2013 Dec;137(12):1832-1836.
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.
References
- 1. Clement PB, Scully RE. Uterine tumors resembling ovarian sex cord tumors. A clinicopathologic analysis of fourteen cases. Am J Clin Pathol 1976;66:512.
- 2. Schraag SM, Caduff R, Dedes KJ, Fink D, Schmidt AM. Uterine tumors resembling ovarian sex cord tumors – treatment, recurrence, pregnancy and brief review. Gynecol Oncol Rep 2017;19:53-56.
- 3. Jeong KH, Lee HN, Kim MK, Kim ML, Seong SJ, Shin E. Successful delivery after conservative resectoscopic surgery in a patient with a uterine tumor resembling ovarian sex cord tumor with myometrial invasion. Obstet Gynecol Sci 2015;58(5):418-422.
- 4. Blake EA, Sheridan TB, Wang KL, et al. Clinical characteristics and outcomes of uterine tumors resembling ovarian sex-cord tumors (UTROSCT): a systematic review of literature. Eur J Obstet Gynecol Reprod Biol 2014;181C:163-170.
- 5. De Franciscis P, Grauso F, Ambrosio D, Torella M, Messalli EM, Colacurci N. Conservative resectoscopic surgery, successful delivery, and 60 months of follow-up in a patient with endometrial stromal tumor with sex-cordlike differentiation. Case Rep Obstet Gynecol 5736865.
- 6. Liu CY, Shen Y, Zhao JG, Qu PP. Clinical experience of uterine tumors resembling ovarian sex cord tumors: a clinicopathological analysis of 6 cases. Int J Clin Exp Pathol 2015;8(4):4158-4164.
- 7. Endo D, Todo Y, Okamoto K, Suzuki H. A case of recurrent group II uterine tumor resembling ovarian sex-cord tumors, against which two hormonal agents were ineffective. Taiwan J Obstet Gynecol 2016 Oct;55(5):751-3.
- 8. Pradhan D, Mohanty SK. Uterine tumors resembling ovarian sex cord tumors. Arch Pathol Lab Med 2013 Dec;137(12):1832-1836.
Details
| Primary Language | English |
|---|---|
| Subjects | Surgery |
| Journal Section | Case Report |
| Authors | |
| Publication Date | March 8, 2019 |
| Submission Date | February 18, 2018 |
| Published in Issue | Year 2017 Volume: 20 Issue: 2 |