BibTex RIS Kaynak Göster

Management of adnexal masses in pregnancy: analysis of 27 cases and review of the literature

Yıl 2008, Cilt: 39 Sayı: 2, 55 - 61, 01.03.2008

Öz

The incidence of adnexal masses in pregnancy is approximately 1%. Most of them are corpus luteum and benign physiological cysts seen in first trimester. 90% of these cysts are resolved spontaneously in the second trimester. The rate of complication such as torsion and rupture in persisted cysts is about 25%. The risk of malignancy is between 2-5%. It is reasonable to perform surgery in cysts with high risk of malignancy or in cysts susceptible to complication, other masses can be treated conservatively. Suitable time for surgery is between 16th and 18th weeks of gestation. The traditional method of management of adnexal masses in pregnancy is laparatomy but in certain conditions laparoscopy can be performed. Most of the ovarian cancers detected inpregnacy are germ cell tumors and these can be operated conservatively. In this paper management of adnexal masses in pregnancy, difficulties in diagnosis, treatment methods and timing were mentioned. Besides that, 27 adnexal masses diagnosed during pregnancy in our clinic were analyzed under the view of the literature. i

Kaynakça

  • I. Hess LW, Peaceman A, Obrien WF, Winkel CA, Cruikshank DP, Morris JC. Adnexal mass occuringwith intrauterine pregnancy. AmJObstet Gynecol 1988; 158:102-109
  • 2 Kumarı I, Kaur S, Mohan H, Huria A. Adnexal masses in pregnancy: a 5-year review.Aust N Z J Obstet Gynaecol 2006 Feb;46(l):52-54
  • 3.PlatekDN, Henderson CE, Goldberg GL. The management of a persistent adnexal mass in pregnancy. Am J Obstet Gynecol 1995; 173: 1236-1241
  • 4. Thanton C, Wells M,. Ovarian cyst in pregnancy. Obstet Gynecol 1987; 69: 717-719
  • 5. Kohler MF. The adnexal mass in pregnancy
  • Postgrad Obstet Gynecol 1994;14: 1-4
  • 6. Liu JR, Lilja JF, Johnson C. Adnexal masses and ovarian cancers in pregnancy, In: Trimble EL, Trimble CL, ed. Cancer Obstetrics and Gynecology, Philadelphia, Lippincott Williams &Wilkins, 1999:239 7. ChittacharoenA, Wanqpusayavisut A, O- Prasertsawat P Adnexal masses in pregnancy. J MedAssoc Thai. 2005 Oct;88 Suppl 2.S37-40
  • 8. Dgani R, Schwartz Z, Atar E, Zosme A, Lancet A. Ovarian cancer during pregnancy. Gynecol Oncol 1989; 33: 326-329
  • 9. Wheler TC, Fleischer AC. Complex adnexal mass in pregnancy, predictive value of color doppler sonograpy. J Ultrasound Med, 1997; 16: 425-428
  • 10. Curtis M, Hopkins MP, Zarlingo T, Martino C. Magnetic resonance imaging to avoid lapa?'atomy in pregnancy. Obstet Gynecol 1993; 82: 833-836
  • II. Bahador A, Lowe MP, Cheng J, Roman LD
  • Gynecologic cancer in pregnancy, In: Gerhenson DM, Me Guire WP,ed. Gynecologic cancer controversies in management, Philedelphia Elsevier 1994:921 12. Bromley B, BenacerrafB. Adnexal masses during pregnancy. J Ultrasound Med. 1997 Jul;16(7):447-52
  • 13. Hogston P, Lilford RJ. Ultrasound study of ovarian cysts in pregnancy, prevelance and significance. BrJObstet Gynecol 1986; 83: 625- 628
  • 14. Whitecar MP, Turner S, HigbykMK. Adnexal masses in pregnancy: A review of 130 cases uundergoing surgical management. Am J Obstet Gynecol 1999 Jul;181(1):19-24
  • 15. Sekmeler KM, Mayo-Smith WW, PeipertJF, Weitsen S, Manuel MD, Gordinier ME. Adnexal masses in pregnancy: surgery compared with observation. Obstet Gynecol 2005 May; 105(5 Pt l):1098-1103
  • 16. StruykAP, Treffers PE. Ovarian tumors in pregnancy. Acta Obstet Gynecol Scand 1984;63(5):421-4
  • 17. Mathevet P, Nessah K, Dargent D, Mellier G. Laparoscopic management of adnexal masses in pregnancy: a case series
  • Eur J Obstet GynecolReprod Biol. 2003 Jun 10;108(2):217-222
  • 18. Ribic-Pucelj M, Kobal B, Peternelj-Marinsek S. Surgical treatment of adnexal masses in pregnancy: indications, surgical approach and pregnancy outcome. J Reprod M. 2007 Apr; 52(4): 273-9
  • 19. Parker WH, Childres JM, Canis M
  • Laparoscopic management of benign cystic teratomas during pregnancy. Am J Obstet Gynecol, 1996 May; 174(5): 1499-501
  • 20. Ready MB, Galon EL, Richars WE
  • Laparoscopy during pregnancy: a survey of laparo-endoscopic sur gens. J Reprod Med 1997; 42: 33-36
  • 21. Yuen PM, Ng PS, Leung PL, Rogers PS
  • Outcome in laparoscopic management of persisitent adnexal masses during the second trimester of pregnancy. Surg Endosc. 2004 Sep;18(9):1354-7. Epub 2004 May 28 22. Liu JR, Lilja JF, Johnson C. Adnexal masses and ovarian cancers in pregnancy, In: Trimble EL, Trimble CL, ed. Cancer Obstetrics and Gynecology, Philadelphia, Lippincott Williams &Wilkins, 1999:239 23. Reynosa EE, SheperdFA, Messner HA. Acute leukemia in pregnancy, he Toronto Leukemia Study Group experience with long-term follow- up of childre n exposed in utero to chemotherapeutic agents. J Clin Oncol. 1987 Jul;5(7):1098-106.
  • 24. Karlen JR Akbari A, Cook WA
  • Dysgerminoma associated with pregnancy. Obstet Gynecol. 1979 Mar; 5 3 (3): 3 30-5
  • 25. Bayhan G, Aban M, Yayla M. Cis-platinium combination chemotherapy during pregnancy for mucinous cystadenocarcinocarcinoma of the ovary. Eur J Gynaecol Oncol. 1999;20(3):231- 2
  • 26. Henderson CE, Giovanni E, Garfunkel D
  • Platinium chemotherapy during pregnancy for serous cystadenocarcinoma of the ovary. Gynecol Oncol. 1993 Apr;49(l):92-4
  • 27. Otton G, Higgins S, Phillips KA. A case of early stage epithelial ovarian cancer in pregnancy. IntJ Gynecol Cancer. 2001 Sep-Oct;ll(5):413-7.

Gebelikte adneksiyel kitleye yaklaşım: 27 olgunun analizi ve literatürün gözden geçirilmesi

Yıl 2008, Cilt: 39 Sayı: 2, 55 - 61, 01.03.2008

Öz

Gebelikte adneksiyel kitle görülme sıklığı %1 civarındadır. Bunların çoğu ilk trimesterde görülen korpus luteum ve fizyolojikfolükül kistleridir. Yüzde doksanı gebeliğin 2. trimesterinde kaybolurlar. Persiste eden kistlerde torsiyon, rüptür gibi komplikasyon çıkarma olasılığı % 25 civarındadır. Malignite görülme olasılığı ise %2-5 arasındadır. Komplikasyon çıkaracağı düşünülen veya malignite riski yüksek kitlelere cerrahi yapmak mantıklı gözükmektedir, diğer kitleler konzervatif izlenebilir. Elekti/ cerrahi için uygun hafta gebeliğin 16-18 haftalarıdır. Gebelik ve adneksiyel kitleye cerrahi yaklaşımda geleneksel yöntem laparatomidir. Ancak laparoskopik girişim belli kurallara uyulursa, uygun bir yöntem olabilir. Gebelikte görülen over kanserlerinin çoğu germ hücreli tümörlerdir bu olgularda konzervatif cerrahi uygulanabilir. Bu yazıda gebelikte görülen adneksiyel kitleye yaklaşım tanıda karşılaşılan güçlükler, tedavi yöntemi ve zamanlamasından bahsedilmiş, ayrıca kliniğimizde gebelikte saptadığımız 27 adneksiyel kitlenin analizi literatür eşliğinde yapılmıştır.

Kaynakça

  • I. Hess LW, Peaceman A, Obrien WF, Winkel CA, Cruikshank DP, Morris JC. Adnexal mass occuringwith intrauterine pregnancy. AmJObstet Gynecol 1988; 158:102-109
  • 2 Kumarı I, Kaur S, Mohan H, Huria A. Adnexal masses in pregnancy: a 5-year review.Aust N Z J Obstet Gynaecol 2006 Feb;46(l):52-54
  • 3.PlatekDN, Henderson CE, Goldberg GL. The management of a persistent adnexal mass in pregnancy. Am J Obstet Gynecol 1995; 173: 1236-1241
  • 4. Thanton C, Wells M,. Ovarian cyst in pregnancy. Obstet Gynecol 1987; 69: 717-719
  • 5. Kohler MF. The adnexal mass in pregnancy
  • Postgrad Obstet Gynecol 1994;14: 1-4
  • 6. Liu JR, Lilja JF, Johnson C. Adnexal masses and ovarian cancers in pregnancy, In: Trimble EL, Trimble CL, ed. Cancer Obstetrics and Gynecology, Philadelphia, Lippincott Williams &Wilkins, 1999:239 7. ChittacharoenA, Wanqpusayavisut A, O- Prasertsawat P Adnexal masses in pregnancy. J MedAssoc Thai. 2005 Oct;88 Suppl 2.S37-40
  • 8. Dgani R, Schwartz Z, Atar E, Zosme A, Lancet A. Ovarian cancer during pregnancy. Gynecol Oncol 1989; 33: 326-329
  • 9. Wheler TC, Fleischer AC. Complex adnexal mass in pregnancy, predictive value of color doppler sonograpy. J Ultrasound Med, 1997; 16: 425-428
  • 10. Curtis M, Hopkins MP, Zarlingo T, Martino C. Magnetic resonance imaging to avoid lapa?'atomy in pregnancy. Obstet Gynecol 1993; 82: 833-836
  • II. Bahador A, Lowe MP, Cheng J, Roman LD
  • Gynecologic cancer in pregnancy, In: Gerhenson DM, Me Guire WP,ed. Gynecologic cancer controversies in management, Philedelphia Elsevier 1994:921 12. Bromley B, BenacerrafB. Adnexal masses during pregnancy. J Ultrasound Med. 1997 Jul;16(7):447-52
  • 13. Hogston P, Lilford RJ. Ultrasound study of ovarian cysts in pregnancy, prevelance and significance. BrJObstet Gynecol 1986; 83: 625- 628
  • 14. Whitecar MP, Turner S, HigbykMK. Adnexal masses in pregnancy: A review of 130 cases uundergoing surgical management. Am J Obstet Gynecol 1999 Jul;181(1):19-24
  • 15. Sekmeler KM, Mayo-Smith WW, PeipertJF, Weitsen S, Manuel MD, Gordinier ME. Adnexal masses in pregnancy: surgery compared with observation. Obstet Gynecol 2005 May; 105(5 Pt l):1098-1103
  • 16. StruykAP, Treffers PE. Ovarian tumors in pregnancy. Acta Obstet Gynecol Scand 1984;63(5):421-4
  • 17. Mathevet P, Nessah K, Dargent D, Mellier G. Laparoscopic management of adnexal masses in pregnancy: a case series
  • Eur J Obstet GynecolReprod Biol. 2003 Jun 10;108(2):217-222
  • 18. Ribic-Pucelj M, Kobal B, Peternelj-Marinsek S. Surgical treatment of adnexal masses in pregnancy: indications, surgical approach and pregnancy outcome. J Reprod M. 2007 Apr; 52(4): 273-9
  • 19. Parker WH, Childres JM, Canis M
  • Laparoscopic management of benign cystic teratomas during pregnancy. Am J Obstet Gynecol, 1996 May; 174(5): 1499-501
  • 20. Ready MB, Galon EL, Richars WE
  • Laparoscopy during pregnancy: a survey of laparo-endoscopic sur gens. J Reprod Med 1997; 42: 33-36
  • 21. Yuen PM, Ng PS, Leung PL, Rogers PS
  • Outcome in laparoscopic management of persisitent adnexal masses during the second trimester of pregnancy. Surg Endosc. 2004 Sep;18(9):1354-7. Epub 2004 May 28 22. Liu JR, Lilja JF, Johnson C. Adnexal masses and ovarian cancers in pregnancy, In: Trimble EL, Trimble CL, ed. Cancer Obstetrics and Gynecology, Philadelphia, Lippincott Williams &Wilkins, 1999:239 23. Reynosa EE, SheperdFA, Messner HA. Acute leukemia in pregnancy, he Toronto Leukemia Study Group experience with long-term follow- up of childre n exposed in utero to chemotherapeutic agents. J Clin Oncol. 1987 Jul;5(7):1098-106.
  • 24. Karlen JR Akbari A, Cook WA
  • Dysgerminoma associated with pregnancy. Obstet Gynecol. 1979 Mar; 5 3 (3): 3 30-5
  • 25. Bayhan G, Aban M, Yayla M. Cis-platinium combination chemotherapy during pregnancy for mucinous cystadenocarcinocarcinoma of the ovary. Eur J Gynaecol Oncol. 1999;20(3):231- 2
  • 26. Henderson CE, Giovanni E, Garfunkel D
  • Platinium chemotherapy during pregnancy for serous cystadenocarcinoma of the ovary. Gynecol Oncol. 1993 Apr;49(l):92-4
  • 27. Otton G, Higgins S, Phillips KA. A case of early stage epithelial ovarian cancer in pregnancy. IntJ Gynecol Cancer. 2001 Sep-Oct;ll(5):413-7.
Toplam 31 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Samet Topuz Bu kişi benim

Ahmet Cem İyibozkurt Bu kişi benim

Süleyman Engin Akhan Bu kişi benim

Sinan Berkman Bu kişi benim

Ergin Bengisu Bu kişi benim

Yayımlanma Tarihi 1 Mart 2008
Yayımlandığı Sayı Yıl 2008 Cilt: 39 Sayı: 2

Kaynak Göster

APA Topuz, S., İyibozkurt, A. C., Akhan, S. E., Berkman, S., vd. (2008). Gebelikte adneksiyel kitleye yaklaşım: 27 olgunun analizi ve literatürün gözden geçirilmesi. Zeynep Kamil Tıp Bülteni, 39(2), 55-61. https://doi.org/10.16948/zktb.63698
AMA Topuz S, İyibozkurt AC, Akhan SE, Berkman S, Bengisu E. Gebelikte adneksiyel kitleye yaklaşım: 27 olgunun analizi ve literatürün gözden geçirilmesi. Zeynep Kamil Tıp Bülteni. Mart 2008;39(2):55-61. doi:10.16948/zktb.63698
Chicago Topuz, Samet, Ahmet Cem İyibozkurt, Süleyman Engin Akhan, Sinan Berkman, ve Ergin Bengisu. “Gebelikte Adneksiyel Kitleye yaklaşım: 27 Olgunun Analizi Ve literatürün gözden geçirilmesi”. Zeynep Kamil Tıp Bülteni 39, sy. 2 (Mart 2008): 55-61. https://doi.org/10.16948/zktb.63698.
EndNote Topuz S, İyibozkurt AC, Akhan SE, Berkman S, Bengisu E (01 Mart 2008) Gebelikte adneksiyel kitleye yaklaşım: 27 olgunun analizi ve literatürün gözden geçirilmesi. Zeynep Kamil Tıp Bülteni 39 2 55–61.
IEEE S. Topuz, A. C. İyibozkurt, S. E. Akhan, S. Berkman, ve E. Bengisu, “Gebelikte adneksiyel kitleye yaklaşım: 27 olgunun analizi ve literatürün gözden geçirilmesi”, Zeynep Kamil Tıp Bülteni, c. 39, sy. 2, ss. 55–61, 2008, doi: 10.16948/zktb.63698.
ISNAD Topuz, Samet vd. “Gebelikte Adneksiyel Kitleye yaklaşım: 27 Olgunun Analizi Ve literatürün gözden geçirilmesi”. Zeynep Kamil Tıp Bülteni 39/2 (Mart 2008), 55-61. https://doi.org/10.16948/zktb.63698.
JAMA Topuz S, İyibozkurt AC, Akhan SE, Berkman S, Bengisu E. Gebelikte adneksiyel kitleye yaklaşım: 27 olgunun analizi ve literatürün gözden geçirilmesi. Zeynep Kamil Tıp Bülteni. 2008;39:55–61.
MLA Topuz, Samet vd. “Gebelikte Adneksiyel Kitleye yaklaşım: 27 Olgunun Analizi Ve literatürün gözden geçirilmesi”. Zeynep Kamil Tıp Bülteni, c. 39, sy. 2, 2008, ss. 55-61, doi:10.16948/zktb.63698.
Vancouver Topuz S, İyibozkurt AC, Akhan SE, Berkman S, Bengisu E. Gebelikte adneksiyel kitleye yaklaşım: 27 olgunun analizi ve literatürün gözden geçirilmesi. Zeynep Kamil Tıp Bülteni. 2008;39(2):55-61.