Overin nadir tümörü: Sklerozan stromal tümör; 7 olgu sunumu ve literatürün gözden geçirilmesi

Yıl 2023, Cilt: 37 Sayı: 1, 79 - 87, 03.04.2023

Duygu Ayaz Sevil Sayhan Tuğba Karadeniz Sibel Demir Keçeci Gamze Aköz

https://doi.org/10.18614/deutip.1166631

Öz

Sklerozan stromal tümörler (STT), genellikle yaşamın 2-3. dekadında genç kadınlarda görülen nadir benign over tümörleridir. Over stromal tümörlerinin %2-6’sını oluştururlar. Çalışmamızda, İzmir Tepecik Eğitim ve Araştırma hastanesi patoloji bölümünde 2011-2020 yılları arasında tanı alan 7 sklerozan stromal tümör olgusunu, klinik ve histopatolojik bulgularını tekrar gözden geçirerek literatür eşliğinde sunduk .
Hastalarımızın yaş ortalaması 34.4 olup 2 hasta postmenopozal dönemdeydi. Olguların 4’ünün klinik takibi mevcut olup 1 hastada operasyondan 7 yıl sonra nüks görüldü. Makroskopik olarak tümörlerin çoğu tamamıyla solid görünümdeydi. Mikroskopik olarak tüm olgularda ödemli ve /veya kollojenden zengin hiposellüler alanlarla ayrılan hipersellüler alanlardan oluşan psödolobüler düzenlenim mevcuttu. Tümör, iğsi şekilli hücreler ve bol berrak – eozinofilik şekilli yuvarlak hücrelerden oluşuyordu.
Çok nadir görülmeleri nedeniyle SST de preoperatif tanı mümkün değildir. Özellikle frozen çalışılan olgularda tipik histopatolojik bulgularla doğru tanı konulması, genç kadın hastalarda fertilite koruyucu cerrahinin uygulanabilmesi açısından önem taşır.

Anahtar Kelimeler

Over, seks kord stromal tümör, sklerozan stromal tümör

A rare tumor of the ovary: Sclerosing stromal tumor; 7 case reports and review the literature

Öz

ABSTRACT
Sclerosing stromal tumors (STT) are rare benign ovarian tumors usually seen in young women in their 2.-3. decades. They constitute 2-6% of ovarian stromal tumors. In our study, we reviewed the clinical and histopathological findings of 7 cases of sclerosing stromal tumors diagnosed between 2011 and 2020 in the pathology department of Tepecik Training and Research Hospital and presented them with the relevant literature.
The average age of our patients was 34.4 years, and 2 patients were in the postmenopausal period. Clinical follow-up was available in 4 of the cases, and recurrence was observed in 1 patient 7 years after the operation. Macroscopically, most of the tumors were completely solid. Microscopically, all cases had a pseudolobular arrangement consisting of hypercellular areas separated by edematous and / or collagen-rich hypocellular areas. The tumor consisted of spindle-shaped cells and plenty of clear-eosinophilic round cells.
Preoperative diagnosis is not possible in SST because of their rarity. Especially in frozen section cases, making a correct diagnosis with typical histopathological findings is important in terms of performing fertility-sparing surgery in young female patients.

Anahtar Kelimeler

Ovary, sex cord stromal tumor, sclerosing stromal tumor

Kaynakça

• 1. Bairwa S, Satarkar RN, Kalhan S, Garg S, Sangwaiya A, Singh P. Sclerosing stromal tumor: a rare ovarian neoplasm. Iran J Pathol. 2017;12:402-5.
• 2. Goebel EA, McCluggage WG, Walsh JC . Mitotically active sclerosing stromal tumor of the ovary: report of a case series with paralels to mitotically active cellular fibroma. International Journal of Gynecological pathology. 2016;00:1-5.
• 3. Atram M, Anshu, Gangane N. Sclerosing stromal tumor of the ovary. Obstet Gynecol Sci. 2014;57:405-8.
• 4. Momtahan M, Akbarzadeh-Jahromi M, Najib FS, Namazi N. Different presentations of five rare cases of sclerosing stromal tumor of the ovary. Indian Journal of Surgical Oncology. 2018;9:581-4.
• 5. Zhao Z, Yan L, Lv H, Liu H. Sclerosing stromal tumor of the ovary in a postmenopausal woman with estrogen excess. Medicine (Baltimore) 2019;98:e18171.
• 6. Naidu A, Chung B, Simon M, Marshall I. Bilateral sclerosing stromal ovarian tumor in an adolescent. Case Rep Radiol. 2015;2015:271394.
• 7. Marelli G, Carinelli S, Mariani A, Frigerio L, Ferrari A. Sclerosing stromal tumor of the ovary: Report of eight cases and review of the literature. European Journal of Obstetrics & Gynecology and Reproductive Biology. 1998;76:85-9.
• 8. McCluggage WG, Staats PN, Kiyokawa T, Young RH. Sex cord-stromal tumours – pure stromal tumours. In: Kurman RJ, Carcangiu ML, Herrington CS, Young RH, editors. WHO Classifications of tumours of female reproductive organs. 4th edition France: IARC; 2014. p.46-7.
• 9. Lee CM, Lim S, Cho HY, Lee J, Shin JW. Sclerosing stromal tumor of the ovary in postmenopausal women. J Menopausal Med. 2015;21:115-9.
• 10. Kaygusuz E I, Cesur S, Çetiner H, Yavuz H, Koç N. Sclerosing stromal tumour in young women: Clinicopathologic and immunohistochemical spectrum. Journal of Clinical and Diagnostic Research. 2013;7:1932-5.
• 11. Yeşil Ş, Tanyıldız HG, Akyürek N, Bozkurt C, Şahin G. A rare presentation of paraovarian sclerosing stromal tumor with high mitotic activity. J Pediatr Adolesc Gynecol. 2016;29:15-5.
• 12.Rana R, Kafle SU, Jha KK, Singh M, Gautam P. Sclerosing stromal tumor of ovary: A case Report.Birat Journal of Health Sciences. 2016;1(1):83-6.
• 13. Khan S, Singh V, Khan MID, Panda S. Sclerosing stromal cell tumor of ovary. Medical Journal Armed Forced Indıa. 2018;74:386-9.