Nadir Görülen Bir Over Tümörü: Sklerozan Stromal Tümör

Öz

Sklerozan stromal tümör (SST) over seks kord stromal tümörleri arasında yer alan oldukça nadir görülen benign bir stromal tümördür. Bu olgu sunumunda sağ overde SST saptanan hastanın, radyolojik bulguları ve histopatolojik özellikleri literatür eşliğinde kısaca tartışılmıştır. 23 yaşında kadın hasta, pelvik ağrı şikayeti ile başvurduğu dış merkezde yapılan abdominal ultrasonografisinde sağ adnekste kistik ve solid komponenti olan kitle lezyon saptanması üzerine ileri tanı ve tedavi için hastanemiz kadın doğum polikliniğine yönlendirildi. Cinsiyet değiştirme istemi de olan hastaya yapılan laboratuvar incelemelerinde herhangi bir hormonal anormallik saptanmadı. Kitlenin frozen incelemesi sonrasında total abdominal histerektomi ve bilateral salpingoooferektomi (TAH+BSO) yapılması kararlaştırıldı. Frozen kesitlerin incelenmesi sonucu “seks kord stromal tümör” olarak değerlendirilen tümörün mikroskopik incelemesinde, kollajenöz ve ödemli hiposellüler alanlar ile hipersellüler alanların oluşturduğu psödolobüler patern, belirgin vasküler proliferasyon izlendi. Morfolojik ve immunhistokimyasal bulgular ışığında sağ overde izlenen tümör “SST” olarak tanı almıştır. Sklerozan stromal tümör olgularının büyük bir kısmı vasküler açıdan zengin solid kitle olduğundan radyolojik olarak öncelikle malign tümör olasılığı akla gelmektedir. SST’nin benign biyolojik davranışa sahip olması ve konservatif cerrahinin gerekli olduğu genç hastalarda görülmesi nedeniyle intraoperatif patolojik tanısı oldukça önemlidir.

Anahtar Kelimeler

• over
• seks kord stromal tümör
• sklerozan stromal tümör

Sclerosing Stromal Tumor: A Rare Case Report

Öz

Sclerosing stromal tumor (SST), an extremely rare benign stromal tumor, is a subtype of sexcord stromal tumors of the ovary. In this report, radiological and histopathological features of the case are briefly discussed in light of the literature. A 23-year-old female patient with a right adnexal mass showing cystic and solid components on abdominal ultrasonography, was referred to our center’s obstetrics clinic for further diagnosis and treatment. The patient had no blood hormonal abnormalities and also had a request for gender change. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed after intraoperative examination of the mass. The diagnosis of sex cord stromal tumor was given intraoperatively and later histopathological examination revealed a pseudolobular pattern formed by collagenous and edematous hyper-hypocellular areas and marked vascular proliferation. Morphological and immunohistochemical findings of the the right ovarian tumor was consistent with "SST". Radiologically, SSTS are diagnosed as a malignant tumor because of the most of them are highly vascular solid masses. For this reason, intraoperative histopathological examination is crucial to prevetn over-treatment, because SST has a benign biological behavior and occurs in young patients which conservative surgery is required.

Anahtar Kelimeler

• Ovary
• Sex Cord Stromal Tumor
• Sclerosing Stromal Tumor

Kaynakça

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