The analyses of data belonging to adolescent age group of patients operated on for adnexal

Yıl 2010, Cilt: 41 Sayı: 4, 183 - 186, 01.05.2010

Zehra Kurdoğlu Mertihan Kurdoğlu E. Gülçin Ay Mansur Kamacı

Öz

Aim: To evaluate operations and histopathological findings of the adolescent age patients who had been operated in our clinic between 2001-2010. Method: The adolescents aged 38 patients who had been operated for adnexal mass at Clinics of Obstetrics and Gynecology, Yuzuncu Yil University were assessed retrospectively. The ages of the patients, the surgeries performed and the histopathologicalfindings were recordedfrom the files. Results: The thirty eight (9.59%) of the patients who had been operated were constituted adolescent age group. The youngest and the oldest patients were 10 and 19 years old, respectively. The mean age was 15.87 years. Thirty (79%) of the patients were treated by laparotomy while 8 patients (21%) were treated laparoscopically. Oophorectomy, cyst extirpation, drainage of an abscess and adhesiolysis and salpingectomy were performed to 12 (31.6 %), 23 (60.5 %), 2 (5.3 %), 1 (2.6 %) of the patients, respectively. The pathology results revealed that 13 of the 39 (34.3 %) patients had mature cystic teratoma, 12 (31.6 %) patients had simple serous cyst, 3 (7.9 %) patients had serous cystadenoma, 2 (5.3 %) patients had serous cystadenocarcinoma, 2 (5.3 %) patients had pelvic abscess, 1 (2.6 %) patient had mucinous cystadenoma, 1 (2.6 %),patient had mucinous cystadenocarcinoma, 1 (2.6 %) patient had dysgerminoma, 1 (2.6 %) patient had corpus luteum hemoragicum cyst, 1 (2.6 %) patient had grade 3 immature teratoma, 1 (2.6 %) patient had ectopic pregnancy. Conclusion: Although the majority of adnexal masses in adolescent age group are composed of mature cystic teratoma and simple serous cyst, rare malign ovarian pathologies should also be kept in mind.

Anahtar Kelimeler

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Kliniğimizde adneksiyel kitle nedeniyle opere edilmiş adolesan yaş grubuna ait verilerin analizi

Öz

Amaç: Adolesan yaş grubunda adneksiyel kitle nedeniyle 2001-2010 yılları arasında kliniğimizde öpere edilen hastalara uygulanan cerrahi yaklaşımları ve histopatolojik sonuçları değerlendirmektir. Yöntem: 2001-2010 yılları arasında Yüzüncü Yıl Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Kliniği 'nde adneksiyel kitle nedeni ile öpere edilen adolesan yaş grubundaki 38 vaka retrospektif olarak incelenmiştir. Dosya verilerinden; hastaların yaşları, uygulanan cerrahi müdahaleler ve histopatolojik sonuçlar kaydedilmiştir. Bulgular: Öpere edilen hastaların 38'i (%9.59) adolesan yaş grubunu oluşturmaktadır. Hastaların en küçüğü 10, en büyüğü 19 yaşında olup yaş ortalaması 15.87' dir. Olguların 30'una (%79) laparotomi uygulanırken 8 'i (%21) i laparoskopik olarak tedavi edilmiştir. 12 (%31.6) hastaya ooforektomi, 23'üne (%60.5) kist ekstirpasyonu, 2 'sine (%5.3) apse drenajı ve adezyoliz ve 1 (%2.6) hastaya da salpenjektomi uygulanmıştır. Patoloji sonuçları incelendiğinde; %34.3'ünün (n=13) matür kistik teratom, %31.6 'sının (n=12) basit seröz kist, %7.9'unun (n—3) seröz kistadenom, %5.3'ünün (n=2) seröz kistadenokarsinom, %5.3'ünün (n=2) pelvik apse, %2.6'sının (n=l) müsinöz kistadenom, %2.6'sının (h=l) müsinöz kistadenokarsinom, %2.6'sının (n=l) disgerminom, %2.6'sının (n=l) korpus luteum hemorajikum kisti, %2.6'sının (n=l) grade III immatür teratom, %2.6'sının (n=l) ektopik gebelik saptanmıştır. Sonuç: Adolesan yaş grubundaki adneksiyel kitlelerin önemli bir kısmını matür kistik teratom ve basit seröz kist oluşturmakla birlikte nadir de olsa bu yaş grubunda malign ovaryan patolojiler de akılda tutulmalıdır.

Anahtar Kelimeler

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Kaynakça

• 1. Özalp S, Yalçın ÖT. Fetal Dönemden Adolesan Döneme Adneksiyel Kitlelerde Yaklaşım. T Klin Jinekol Obst 2002; 12; 493-497
• 2. Schultz KA, Ness KK, Nagarajan R, Steiner ME. Adnexal masses in infancy and childhood. Clin Obstet Gynecol. 2006; 49; 464-479
• 3. Fotiou SK. Ovarian malignancies in adolescence. Ann N Y Acad Sci 1997; 816; 338-346
• 4. Tintara H, Mitarnun W. Ovarian neoplasms in childhood and adolescents in Songklanagarind Hospital, February 1983-March 1989. J Med Assoc Thai 1990; 73; 375-380
• 5. WHO World Health Organization (1998). The second decade: improving adolescent health and development. Programme brochure. Geneva: WHO, Department of Child and Adolescent Health and Development
• 6. King DR. Ovarian cysts and tumors. In: Welch KJ,Randolph JG, Ravitch MM, eds. Pediatric Surgery. 4th ed. Chicago, IL: Year Book, 1986:1341-52
• 7. Piippo S, Mustaniemi L, Lenko H, Aine R, Maenpaa J. Surgery for ovarian masses during childhood and adolescence: A report of 79 cases. J Pediatr Adolesc Gynecol 1999; 12; 223-227
• 8. Aggarwal A, Lucco KL, Lacy J, Kives S, Gerstle JT, Allen L. Ovarian epithelial tumors of low malignant potential: a case series of 5 adolescent patients. J Pediatr Surg. 2009; 44;2023-2027
• 9. Esin S,Doğan NU, Bozdağ G, Çelik H, Ayhan A. Adolesanlarda Over Tümörleri. Türkiye Klinikleri J Pediatr Sci 2006; 2; 80-88
• 10. Fotiou SK. Ovarian malignancies in adolescence.Ann N Y Acad Sci. 1997; 816; 338-346
• 11. Einarsson JI, Edwards CL, Zurawin RK. Immature ovarian teratoma in an adolescent: a case report and review of the literature. J Pediatr & Adolesc Gynecol 2004; 17; 187-189
• 12. Mayer JP, Bettolli M, Kolberg-Schwerdt A. et al. Laparoscopic approach to ovarian mass in children and adolescents: already a standard in therapy. J Laparoendosc Adv Surg Tech A. 2009; 19 Suppl 1; 111-115
• 13. Tsikouras P, Liberis V, Galazios G. et al. Laparoscopic treatment of ovarian dermoid cysts. Clin Exp Obstet Gynecol 2008; 35; 124-129
• 14. Michelotti B, Segura BJ, Sau I, Perez-Bertolez S, Prince JM, Kane TD. Surgical management of ovarian disease in infants, children, and adolescents: a 15-year review. J Laparoendosc Adv Surg Tech A. 2010; 20; 261-264