Opere edilen 51 fibrom/fibrotekom vakasının klinikopatolojik bulgularının değerlendirilmesi

Yıl 2021, Cilt: 7 Sayı: 3, 176 - 182, 31.12.2021

Ferah Kazancı Arda İnan Özlem Erdem Mehmet Anıl Onan Neslihan Yerebasmaz

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.

Anahtar Kelimeler

Jinekolojik onkoloji, Ovarian fibroma, Fibrotekoma

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

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.

Anahtar Kelimeler

Gynecologic oncology, Ovarian fibroma, Fibrothecoma

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.