OVER KANSERİNE İKİNCİL PRİMER VAJİNAL YASSI HÜCRELİ KANSER

Öz

Over kanseri hastalar›nda ikincil primer kanser izlenebilmektedir. Bununla birlikte, ikincil primer kanser olarak vajinal yassı hücreli kanser literatürde bildirilmemiştir. Postmenapozal, 51 yaşındaki on yıllık diabetik ve hipertansif, hasta bilateral adneksiyal kitle ile başvurdu. Serum CA-125 değeri 74,6 U/mL bulundu. Laparatomi sırasında yollanan frozen sonucu, bilateral over kapsülleri intakt ancak overler içinde bazı odaklarda malignite varlığı bildirildi. Batın sitoloji negatif değerlendirildi. Altı kür adjuvan karboplatin/paklitaksel tedavisi verildi. Beş yıl sonra rekürrens gelişti ve aynı ajanlar tekrar verildi. İkincil bakış laparotomisi negatif bulundu. Daha sonra hastada kronik böbrek yetmezliği geliflti ve dialize başlandı. Bir yıl sonra da vajen ön duvarda, vajinal kaf yakınında yassı hücreli kanser saptandı. Cerrahi tedaviyi kabul etmeyen hastaya radyoterapi/karboplatin verildi. Primer kanser tanısının dokuzuncu yılında hastanın metastatik akciğer lezyonu tespit edildi. Karboplatin/paklitaksel tekrar başlandı. Jinekolojik kanserli hastalarda ikincil primer kanser riskinin artması alınan kemoterapiler, uzayan sağ kalım, herediter ve sistemik hastalıklar gibi genel etiyolojik nedenlere bağlı olabilir. Dikkatli izlem önerilir.

Anahtar Kelimeler

• Over kanseri, vajen kanseri, ikincil kanser

Öz

Second primary cancers in patients with ovarian cancer can be observed. However, vaginal squamous cell cancer as a second primary cancer has not been reported in the literature. A postmenopausal, 51-year-old woman hypertensive and diabetic for ten years, admitted with bilateral adnexal masses. Serum CA- 125 value was found as 74.6 U/ml. Intra-operative frozen section reported that bilateral ovarian capsules were intact, but there were ovarian malignancies in some foci. Abdomen cytology was evaluated as negative. Six cycles of adjuvant carboplatin/paclitaxel treatment was given. Recurrence developed five years later and the same agents were again given. Second-look laparotomy was negative. Later, patient developed chronic renal failure, and dialysis was started. One year later, squamous cell carcinoma was detected at the anterior wall of the vagina, next to the vaginal cuff. Radiotherapy/carboplatin was given to the patient who declined surgical treatment. Patient’s metastatic lung lesion was detected in the ninth year of primary cancer diagnosis. Carboplatin/paclitaxel was restarted. In patients with gynecological cancer, increased risk of second primary cancers may be due to the common etiologic causes such as chemotherapies, prolonged survival, hereditary and systemic diseases. Careful follow-up is advised.

Anahtar Kelimeler

• Ovarian cancer, vaginal cancer, second cancer

Kaynakça

1. 1. Curtis RE, Hoover RN, Kleinerman RA, Harvey EB. Second cancer following cancer of the female genital system in Connecticut, 1935-82. Natl Cancer Inst Monogr. 1985;68:113-137.
2. 2. Reimer RR, Hoover R, Fraumeni JF Jr, Young RC. Second primary neoplasms following ovarian cancer. J Natl Cancer Inst. 1978;61:1195-1197.
3. 3. Bergfeldt K, Einhorn S, Rosendahl I, Hall P. Increased risk of second primary malignancies in patients with gynecological cancer. A Swedish record-linkage study. Acta Oncol. 1995;34:771-777.
4. 4. Dorr FA, Coltman CA Jr. Second cancers following antineoplastic therapy. Curr Probl Cancer. 1985;9:1-43