MATÜR KİSTİK TERATOMLARDA TÜMÖR MARKERLERİ

Öz

Amaç: Çalışmamızda, dermoid kistlerin cerrahi tedavisindeki deneyimlerimiz ile tümör markerleri arasındaki ilişkinin araştırılması. Materyal ve Metod: 2005–2011 yılları arasında kliniğimizde dermoid kist ön tanısıyla laparoskopi veya laparotomi uygulanan ya da değişik nedenlerle sezaryen operasyonu yapılıp aynı anda dermoid kistektomi uygulanan 122 olgunun verileri retrospektif olarak değerlendirildi. Arşiv kayıtlarından olguların yaşları, preoperatif ultrasonografik kist boyutu, bilateralite durumu, tümör belirteçleri, intraoperatif yapılan işlem ve kesin patolojik tanıları kaydedildi. Verilerin de- ğerlendirilmesinde tanımlayıcı istatistik kullanıldı ve değişkenler % ve ortalama±standart sapma olarak kullanıldı. Bulgular: Cerrahi olarak müdahale edilen dermoid kist boyutları 3-25 cm arasında olup, ortalama boyut 7,38±3,69 cm idi. 92 hastaya laparoskopik girişimle kistektomi uygulanmış, 30 hastaya ise laparotomi yapılmıştır. Laparotomi yapılan hastaların 10 tanesi postmenopozal dönemde olup myoma uteri veya çeşitli servikal neoplastik lezyonlara sahipti. 6 hasta tümör boyutlarının 15 cm’i aşması nedeniyle laparotomiye alınmış ve 14 hastaya ise çeşitli obstetrik endikasyonlarla yapılan sezaryen operasyonu sırasında kistektomi yapılmıştır. Bakılan tümör belirteçlerinden CA125 değeri, bilateral kist bulunan olgularda ve CA 19-9 değeri kist boyutunun 15 cm’yi aştığı durumlarda, istatistiksel olarak anlamlı şekilde yüksek bulunmuştur. Sonuç: Dermoid kistler çok büyük boyutlara ulaşabilmekte ve kesin tedavileri cerrahi yolla yapılmaktadır. Dermoid kist düşünülen olgularda özellikle CA 125 yüksekliğinde kistin bilateral olabileceği ve 15 cm’yi aşan kistlerde CA 19-9 düzeyinin artabileceği göz önünde bulundurulmalıdır.

Anahtar Kelimeler

• Dermoid Kist, Cerrahi Tedavi, CA125,CA 19-9

Öz

Purpose: The aim of this study is to overview our experience in surgical treatment of mature cystic teratomas (dermoid cysts) and to examine the relation with tumor markers . Material and Method: We retrospectively analysed the results of 122 patients who underwent laparoscopy or laparotomy due to dermoid cysts and in whom dermoid cysts were diagnosed during cesarean section incidentally between the years 2005 and 2011 in our clinic. From the records; the age of the patients, preoperative size of the cysts, bilaterally or unilaterally, tumour markers, operation type and pathologic results are abtained. Descriptive statistics were used to assess the data and variables used in% and the mean ± standard deviation. Findings: Surgically treated dermoid cysts were between 3-25 cm and mean size was 7.38±3.69 cm. In 92 patients, laparoscopy performed and in 30 patients laparotomy was the method of operation. Among patients underwent laparotomy; 10 patients were in postmenopausal period and had additional problems since myoma uteri or different cervical neoplastic lesions. 6 patients underwent laparatomy because of the large tumour size (>15 cm). In 14 patients dermoid cysts were observed incidentally during cesarean sections and were extirpated. CA 125 levels are found high in statisticially significant levels in bilateral tumours. It is also found that CA 19-9 levels increase to statisticially significant levels in tumours bigger than 15 cm in diameter. Conclusion: Mature cystic teratomas can reach to very big sizes and treatment can be done surgically. It must be remembered in mind that in cases with high CA 125 levels, the dermoid cyst may be bilateral and CA 19-9 levels may be high in dermoid cysts bigger than 15 cm.

Anahtar Kelimeler

• Mature Cystic Teratoma, Surgical Treatment, CA 125, CA 19-9

Kaynakça

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