M. Ali VARDAR, A. Barış GÜZEL, Ümran KÜÇÜKGÖZ GÜLEÇ, Arbil AÇIKALIN, Emine KILIÇ BAĞIR, Derya GÜMÜRDÜLÜ

Overin Primer ve Metastatik Müsinöz Tümörlerine Algoritmik Yaklaşım

Amaç: Bu çalışmanın amacı overin primer ve metastatik müsinöz tümörlerinde ayırıcı tanıda histopatolojik özelliklere ek olarak immünohistokimyasal bulgular, tümör boyutu ve lateralitenin primer – metastaz ayırımındaki tanısal değerini araştırmaktır. Gereç ve Yöntemler: Hastanemizde 2001-2012 yılları arasında tanı alan 222 müsinöz over tümörü olguları patoloji arşivinden retrospektif olarak tarandı. Olgular yaş, lateralizasyon, tümör boyutu ve immünohistokimyasal olarak değerlendirildi. Bulgular: Çalışmaya dahil edilen 222 olgunun 195’i primer müsinöz over tümörü, 27’si metastatik müsinöz tümör tanısı almış idi. Primer olguların kendi içinde dağılımları sırası ile kistadenomlar 135/195, müsinöz karsinomlar 31/195 ve borderline tümörler 29/195 idi. Olguların yaş ortalaması 48,7 14y-72y idi. Lateraliteye bakıldığında borderline tümörlerin 29/29 ve müsinöz karsinomların 27/31 tek overde görülme oranları daha yüksek iken metastatik tümörlerde bu oran daha düşük idi 11/27 . Tümör boyutları değerlendirildiğinde primer tümörlerde boyutun daha yüksek olduğu metastatik lezyonlarda tümör boyutunun daha düşük olduğu tespit edildi. Sonuç: Müsinöz tümörler, over tümörleri içerisinde metastaz ve primer ayırımının yapılması gereken önemli bir gruptur. Metastatik tümörlerin büyük bir kısmı primer over tümörünü taklit ederler ancak metastaz-primer ayırımında tümör boyutu ve lateralitenin önemli bir veri olduğunu bunun yanında immünohistokimyanın da tanısal doğruluğu artırmada yararlı olacağını düşünmekteyiz

Anahtar Kelimeler:

Over, Müsinöz tümör, Borderline tümör, Metastatik

Algorithmic Approach to Primary and Metastatic Mucinous Ovarian Tumors

Objective: The aim of this study was to investigate the importance of immunohistochemical findings and tumor size and laterality in addition to the histopathological features in the diagnosis of primary and metastatic mucinous tumors of the ovary.Material and Methods: Two hundred and twenty two mucinous ovarian tumors diagnosed between 2001 and 2012 were retrospectively reviewed in our hospital pathology archive. The cases were evaluated for age, lateralization, tumor size and immunohistochemistry.Results: Of the 222 cases included in the study, 195 were diagnosed as primary mucinous tumor and 27 as metastatic mucinous tumor. The distribution of the primary cases was cystadenomas in 135/195, mucinous carcinomas in 31/195 and borderline tumors in 29/195 cases. The mean age of the patients was 48.7 years range 14y-72y . When laterality was evaluated, borderline tumors 29/29 and mucinous carcinomas 27/31 had a higher incidence in a single ovary but this rate was lower in metastatic tumors 13/27 . When tumor size was evaluated, it was found that tumor size was lower in metastatic lesions while the size of the primary tumors was larger.Conclusion: Mucinous tumors are an important group where the differentiation of metastasis and primary lesion should be performed. Most of the metastatic tumors mimic the primary ovarian tumor, but we think that tumor size and laterality are important for the differentiation between metastasis and primary while immunohistochemistry may be useful in increasing the diagnostic accuracy

Keywords:

Ovary, Mucinous tumor, Borderline tumor, Metastatic,

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