PERİMENOPOZAL ANORMAL UTERİN KANAMA OLAN BİR HASTADA TESPİT EDİLEN PRİMER ODAĞI BELİRLENEMEYEN MÜSİNÖZ ADENOKARSİNOM OLGUSU

Öz

Primer odağı belirlenemeyen kanserler (POBK), iyi tanımlanmış olmasına karşın, onkoloji pratiğinde gerek tanı, gerek tedavi açısından sorunlu bir konudur. Bu tip kanserlerin %80’i adenokanserlerden oluflmakta ve söz konusu tanıyı koyabilmek için kapsamlı klinik, patolojik ve laboratuar değerlendirmeler gerekmektedir. Bu yazıda perimenopozal dönemde anormal uterin kanama ile baflvuran bir hastada, primer odağı apendiks olarak düflünülen ancak tümör odağının kesin olarak saptanamadığı bir müsinöz adenokarsinom olgusu sunulmaktadır

Anahtar Kelimeler

• Anormal Uterin Kanama, Primer Odağı Belirlenemeyen Kanser, Müsinöz Apendiks Adenokarsinomu.

Öz

Although the concept of “cancer of unknown origin” is welldescribed, the diagnostic and therapeutic approaches for these tumors are problematic. Adenocarcinomas comprise 80%of cancers of unknown origin. A thorough clinical, pathologic and laboratory evaluation is mandatory to make a correct diagnosis in these cases. In this report, we describe a woman presenting with perimenopausal abnormal uterine bleeding, which was consequently diagnosed as a mucinous adenocarcinoma of unknown origin, likely originating from the vermiform appendix.

Anahtar Kelimeler

• Abnormal Uterine Bleeding, Cancer of Unknown Origin, Mucinous Appendiceal Adenocarcinoma.

Kaynakça

1. 1. American Cancer Society. Statistics for 2007. American Cancer Society Statistics. Available at http://www.cancer.org/Research/CancerFactsFigures/index. Accessed July 11, 2007.
2. 2. Cancer of unknown primary site. The Presentation of Adenocarcinoma of the Uterine Cervix. Cancer Volume 72, Issue 4, pages 1281–1285, 15 August 1993.
3. 3. Pavlidis N, Pentheroudakis G. Cancer of unknown primary site. Lancet. 2012 Apr 14;379(9824):1428-35. Epub 2012 Mar 12. Review.
4. 4. Pentheroudakis G, Golfinopoulos V, Pavlidis N. Switching benchmarks in cancer of unknown primary: from autopsy to microarray. Eur J Cancer 2007; 43: 2026–36.
5. 5. Chu PG, Chung L, Weiss LM, Lau SK. Determining the site of origin of mucinous adenocarcinoma: an immunohistochemical study of 175 cases. Am J Surg Pathol. 2011 Dec;35(12):1830-6.
6. 6. McCusker ME, Coté TR, Clegg LX, Sobin LH. Primary malignant neoplasms of the appendix: a populationbased study from the surveillance, epidemiology and end-results program, 1973-1998. Cancer. 2002;94:3307–3312.
7. 7. Connor SJ, Hanna GB, Frizelle FA. Appendiceal tumors: retrospective clinicopathologic analysis of appendiceal tumors from 7,970 appendectomies. Dis Colon Rectum. 1998;41:75–80.
8. 8. Conte CC, Petrelli NJ, Stule J, Herrera L, Mittelman A. Adenocarcinoma of the appendix. Surg Gynecol Obstet. 1988;166:451–453.

9. 9. Lee J, Gardiner KR, Wilson BG. Incidental mucinous cystadenocarcinoma of the appendix. Postgrad Med J. 1996;72(843):55–56. doi: 10.1136/pgmj.72.843.55.
10. 10. Nitecki SS, Wolff BG, Schlinkert R, Sarr MG. The natural history of surgically treated primary adenocarcinoma of the appendix. Ann Surg. 1994;219:51–57.
11. 11. Lo NS, Sarr MG. Mucinous cystadenocarcinoma of the appendix. The controversy persists: a review. Hepatogastroenterology. 2003;50(50):432–437.
12. 12. Topkan E, Polat Y, Karaoglu A. Primary mucinous adenocarcinoma with chemotherapy and radiotherapy. A case report. Tumori. 2008;94:596–599