Araştırma Makalesi
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Opere edilen 51 fibrom/fibrotekom vakasının klinikopatolojik bulgularının değerlendirilmesi

Yıl 2021, , 176 - 182, 31.12.2021
https://doi.org/10.30569/adiyamansaglik.877746

Öz

Amaç: Over kaynaklı fibrom/fibrotekomlar benign neoplazmlardır. Bu çalışmada amacımız opere edilen fibrom/fibrotekom vakalarının klinik bulguları, demografik özellikleri, cerrahi yaklaşımları ve histopatolojik sonuçlarıyla değerlendirmektir.
Gereç ve Yöntem: Bu retrospektif çalışmada adneksiyel kitle ön tanısı ile opere edilen ve patoloji sonucu fibrom/fibrotekom olan 51 vaka analiz edildi.
Bulgular: Hastaların yaş ortalaması 58,7, tümör çapı ortalama 8,23 cm idi. Nihai patoloji sonuçlarında fibrom, fibrotekom, seluler mitotik fibrom oranları sırasıyla %45, %35, %13,7 idi. Vakaların 6 (%11,7) inde asit izlendi. Ca-125 seviyesi 12 (%23,5) vakada yüksek saptandı. 11 (%21,6) vakaya laparoskopi, 40 (%78,4) vakaya laparotomi yapıldı.
Sonuç: Over kaynaklı fibrom/fibrotekomlar nadir, benign solid tümörlerdir. Solid olmasından dolayı myomlarla ve bazende Ca-125 yüksekliği ile seyrettiğinden malignensilerle karışabilirler. Hastalar laparoskopi veya laparotomi ile başarılı olarak tedavi edilirler.

Kaynakça

  • Numanoglu C, Kuru O, Sakinci M, et al. Ovarian fibroma/fibrothecoma: retrospective cohort study shows limited value of risk of malignancy index score. Aust N Z J Obstet Gynaecol. 2013;53(3):287–292.
  • Sivanesaratnam V, Dutta R, Jayalakshmi P. Ovarian fibroma–clinical and histopathological characteristics. Int J Gynaecol Obstet. 1990;33(3):243–247.
  • Sfar E, Ben Ammar K, Mahjoub S, et al.Anatomo-clinical characteristics of ovarian fibrothecal tumors. 19 cases over 12 years:1981–1992. Rev Fr Gynecol Obstet 1994; 89:315–321.
  • Gargano G, De Lena M, Zito F, et al. Ovarian fibroma: our experience of 34 cases. Eur J Gynaecol Oncol 2003; 24: 429–432.
  • Paladini D, Testa A, Van Holsbeke C, et al. Imaging in gynecological disease (5): clinical and ultrasound characteristics in fibroma and fibrothecoma of the ovary. Ultrasound Obstet Gynecol. 2009;34(2):188–195.
  • Genc M, Solak A, Genc B, et al. A diagnostic dilemma for solid ovarian masses: the clinical and radiological aspects with differential diagnosis of 23 cases. Eur J Gynaecol Oncol.2015;36(2):186–191.
  • Chen H, Liu Y, Shen LF, et al. Ovarian thecoma-fibroma groups: clinical and sonographic features with pathological comparison. J Ovarian Res 2016;9:81.
  • Chechia A, Attia L, Temime RB, et al. Incidence, clinical analysis, and management of ovarian fibromas and fibrothecomas. Am J Obstet Gynecol 2008; 199: 473.e1–e4.
  • Cho YJ, Lee HS, Kim JM, et al. Clinical characteristics and surgical management options for ovarian fibroma/fibrothecoma: a study of 97 cases. Gynecol Obstet Invest. 2013;76:182–7.
  • Jung NH, Kim T, Kim HJ, et al. Ovarian sclerosing stromal tumor presenting as Meigs’ syndrome with elevated CA-125. J Obstet Gynaecol Res 2006;32:619–22.
  • Son CE, Choi JS, Lee JH, et al.Laparoscopic surgical management and clinical characteristics of ovarian fibromas. JSLS 2011; 15: 16–20.
  • Târcoveanu E, Dimofte G, Niculescu D, et al. Ovarian fibroma in the era of laparoscopic surgery: a general surgeon’s experience. Acta Chir Belg 2007; 107: 664–669.
  • Tinelli A, Pellegrino M, Malvasi A, et al. Laparoscopical management ovarian early sex cord-stromal tumors in postmenopausal women: a proposal method. Arch Gynecol Obstet 2011; 283(suppl 1):87–91.
  • Kurman RJ, Carcangiu ML, Herrington S, et al. World Health Organization Classification of Tumours of the Female Reproductive Organs. IARC, Lyon, 2014. Copyright © 2014.
  • Leung SW, Yuen PM. Ovarian fibroma: A review on the clinical characteristics, diagnostic difficulties, and management options of 23 cases. Gynecol Obstet Invest 2006;62:1-6.
  • Parwate NS, Patel SM, Arora R. Ovarian Fibroma: A clinico-pathological study of 23 cases with review of literatüre. J Obstet & Gynecol Indina.2016; 66(6):460-465.
  • Prat J, Scully RE: Cellular fibromas and fibrosarcomas of the ovary: a comparative clinicopathologic analysis of seventeen cases. Cancer 1981; 47: 2663–2670.
  • Irving JA, Alkushi A, Young RH, Clement PB. Cellular fibromas of the ovary: a study of 75 cases including 40 mitotically active tumors emphasizing their distinction from fibrosarcoma. Am J Surg Pathol 2006; 30: 928–38.
  • Young RH. Ovarian sex cord-stromal tumours and their mimics. Pathology: 2018;50(1):5-15
  • Dockerty MB, Masson JC: Ovarian fi bromas: a clinical and pathologic study of 283 cases. Am J Obstet Gynecol 1944; 47: 741.
  • Cha MY, Roh HJ, You SK, et al. Meigs’ syndrome with elevated serum CA 125 level in a case of ovarian fibrothecoma. Eur J Gynaecol Oncol 2014;35:734–737
  • Sofoudis C, Kouiroukidou P, Louis K, et al. Enormous ovarian fibroma with elevated Ca-125 associated with Meigs’ syndrome. Presentation of a rare case. Eur J Gynaecol Oncol 2016;37:142–143.
  • Chan WY, Chang CY, Yuan CC, et al. Correlation of ovarian fibroma with elevated serum CA-125. Taiwan J Obstet Gynecol 2014;53:95–96.
  • Young RH. Thecoma of the ovary: a report of 70 cases emphasizing aspects of its histopathology different from those often portrayed and its differential diagnosis. Am J Surg Pathol. 2014;38(8):1023–1032.
  • Renaud MC, Plante M, Roy M. Ovarian thecoma associated with a large quantity of ascites and elevated serum CA 125 and CA 15-3. J Obstet Gynecol Can 2002;24:963-965.

Clinicopathological analysis and surgical approach of ovarian fibroma/fibrothecoma with 51 cases

Yıl 2021, , 176 - 182, 31.12.2021
https://doi.org/10.30569/adiyamansaglik.877746

Öz

Aim: Ovarian fibroma, fibrothecoma and thecoma are benign neoplasia of the ovary. The aim of this study is to analyze the clinical characteristics, histopathological results and surgical management of ovarian fibroma/fibrothecoma.
Materials and Methods: This is a retrospective study of 51 cases who underwent surgical treatment because of adnexial mass. The cases reported as ovarian fibroma/fibrothecomas were analyzed.
Results: The mean age of patients were 58.7 years old. The avarage diameter of tumours was 8.23 cm. The final pathological results were fibroma, fibrothecoma, celluler mitotic fibroma, respectively 45.2%, 35.3%, 13.7%. Ascite was viewed in 6 (11.7%) cases. Ca-125 levels were high in 12 cases (23.5%). 11(21.6%) patients underwent laparoscopy and 40 (78.4%) underwent laparotomy.
Conclusion: Ovarian fibroma/fibrothecomas are rarely, benign solid tumors. They can be mistaken as myoma or malignancy because of the apperance of tumor with high level Ca-125. These tumors can be treated succesfully by laparoscopy or laparotomy.

Kaynakça

  • Numanoglu C, Kuru O, Sakinci M, et al. Ovarian fibroma/fibrothecoma: retrospective cohort study shows limited value of risk of malignancy index score. Aust N Z J Obstet Gynaecol. 2013;53(3):287–292.
  • Sivanesaratnam V, Dutta R, Jayalakshmi P. Ovarian fibroma–clinical and histopathological characteristics. Int J Gynaecol Obstet. 1990;33(3):243–247.
  • Sfar E, Ben Ammar K, Mahjoub S, et al.Anatomo-clinical characteristics of ovarian fibrothecal tumors. 19 cases over 12 years:1981–1992. Rev Fr Gynecol Obstet 1994; 89:315–321.
  • Gargano G, De Lena M, Zito F, et al. Ovarian fibroma: our experience of 34 cases. Eur J Gynaecol Oncol 2003; 24: 429–432.
  • Paladini D, Testa A, Van Holsbeke C, et al. Imaging in gynecological disease (5): clinical and ultrasound characteristics in fibroma and fibrothecoma of the ovary. Ultrasound Obstet Gynecol. 2009;34(2):188–195.
  • Genc M, Solak A, Genc B, et al. A diagnostic dilemma for solid ovarian masses: the clinical and radiological aspects with differential diagnosis of 23 cases. Eur J Gynaecol Oncol.2015;36(2):186–191.
  • Chen H, Liu Y, Shen LF, et al. Ovarian thecoma-fibroma groups: clinical and sonographic features with pathological comparison. J Ovarian Res 2016;9:81.
  • Chechia A, Attia L, Temime RB, et al. Incidence, clinical analysis, and management of ovarian fibromas and fibrothecomas. Am J Obstet Gynecol 2008; 199: 473.e1–e4.
  • Cho YJ, Lee HS, Kim JM, et al. Clinical characteristics and surgical management options for ovarian fibroma/fibrothecoma: a study of 97 cases. Gynecol Obstet Invest. 2013;76:182–7.
  • Jung NH, Kim T, Kim HJ, et al. Ovarian sclerosing stromal tumor presenting as Meigs’ syndrome with elevated CA-125. J Obstet Gynaecol Res 2006;32:619–22.
  • Son CE, Choi JS, Lee JH, et al.Laparoscopic surgical management and clinical characteristics of ovarian fibromas. JSLS 2011; 15: 16–20.
  • Târcoveanu E, Dimofte G, Niculescu D, et al. Ovarian fibroma in the era of laparoscopic surgery: a general surgeon’s experience. Acta Chir Belg 2007; 107: 664–669.
  • Tinelli A, Pellegrino M, Malvasi A, et al. Laparoscopical management ovarian early sex cord-stromal tumors in postmenopausal women: a proposal method. Arch Gynecol Obstet 2011; 283(suppl 1):87–91.
  • Kurman RJ, Carcangiu ML, Herrington S, et al. World Health Organization Classification of Tumours of the Female Reproductive Organs. IARC, Lyon, 2014. Copyright © 2014.
  • Leung SW, Yuen PM. Ovarian fibroma: A review on the clinical characteristics, diagnostic difficulties, and management options of 23 cases. Gynecol Obstet Invest 2006;62:1-6.
  • Parwate NS, Patel SM, Arora R. Ovarian Fibroma: A clinico-pathological study of 23 cases with review of literatüre. J Obstet & Gynecol Indina.2016; 66(6):460-465.
  • Prat J, Scully RE: Cellular fibromas and fibrosarcomas of the ovary: a comparative clinicopathologic analysis of seventeen cases. Cancer 1981; 47: 2663–2670.
  • Irving JA, Alkushi A, Young RH, Clement PB. Cellular fibromas of the ovary: a study of 75 cases including 40 mitotically active tumors emphasizing their distinction from fibrosarcoma. Am J Surg Pathol 2006; 30: 928–38.
  • Young RH. Ovarian sex cord-stromal tumours and their mimics. Pathology: 2018;50(1):5-15
  • Dockerty MB, Masson JC: Ovarian fi bromas: a clinical and pathologic study of 283 cases. Am J Obstet Gynecol 1944; 47: 741.
  • Cha MY, Roh HJ, You SK, et al. Meigs’ syndrome with elevated serum CA 125 level in a case of ovarian fibrothecoma. Eur J Gynaecol Oncol 2014;35:734–737
  • Sofoudis C, Kouiroukidou P, Louis K, et al. Enormous ovarian fibroma with elevated Ca-125 associated with Meigs’ syndrome. Presentation of a rare case. Eur J Gynaecol Oncol 2016;37:142–143.
  • Chan WY, Chang CY, Yuan CC, et al. Correlation of ovarian fibroma with elevated serum CA-125. Taiwan J Obstet Gynecol 2014;53:95–96.
  • Young RH. Thecoma of the ovary: a report of 70 cases emphasizing aspects of its histopathology different from those often portrayed and its differential diagnosis. Am J Surg Pathol. 2014;38(8):1023–1032.
  • Renaud MC, Plante M, Roy M. Ovarian thecoma associated with a large quantity of ascites and elevated serum CA 125 and CA 15-3. J Obstet Gynecol Can 2002;24:963-965.
Toplam 25 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makalesi
Yazarlar

Ferah Kazancı 0000-0002-3910-0821

Arda İnan 0000-0002-6179-2828

Özlem Erdem Bu kişi benim 0000-0002-8396-458X

Mehmet Anıl Onan Bu kişi benim 0000-0001-7643-1585

Neslihan Yerebasmaz 0000-0002-3910-0821

Yayımlanma Tarihi 31 Aralık 2021
Gönderilme Tarihi 23 Mart 2021
Kabul Tarihi 17 Ağustos 2021
Yayımlandığı Sayı Yıl 2021

Kaynak Göster

AMA Kazancı F, İnan A, Erdem Ö, Onan MA, Yerebasmaz N. Clinicopathological analysis and surgical approach of ovarian fibroma/fibrothecoma with 51 cases. ADYÜ Sağlık Bilimleri Derg. Aralık 2021;7(3):176-182. doi:10.30569/adiyamansaglik.877746