N. ASKAR, Z BAYRAK, G. S. DEMİRTAŞ, M C TEREK, Y. DİKMEN, O. ZEKİOĞLU

Cerrahi sonrası hızlı tekrarlayan andiferansiye uterin sarkom

Uterus sarkomları tüm jinekolojik malignitelerin %1ini ve uterus malignitelerinin de %3-7sini oluştururlar. Erken evrede tanı konulan hasta oranı yüksek olmasına rağmen sağkalım oranı düşük bir hastalıktır. Hastalar kliniğe genellikle anormal vajinal kanama, abdominal rahatsızlık ve pelvik kitle yakınması ile başvururlar. Uterus sarkomlar hızlı ilerleyen tümörlerdir; bölgesel yineleme ve uzak metastaz yapma eğilimleri fazladır. Hastalarda %34-64 arası nüks bildirilmiştir. Nükslerin büyük çoğunluğu ilk iki yıl içinde görülür. Burada sunduğumuz olgu 52 yaşında postmenopozal dönemde kadın kliniğimize kasık ağrısı yakınması ile başvurmuştur. Hastanın yapılan alt abdomen manyetik rezonans incelemesinde uterus fundustan kaynaklanan 15x11 cm kitle dejenere myom nüvesi lehine değerlendirilmiş ve hastaya abdominal total histerektomi ve sol salpigoooferektomi uygulanmıştır. Patoloji sonucu andiferansiye uterin sarkom olarak gelen olguda cerrahi sonrası 25. günde alt abdomino-pelvik bilgisayarlı tomografi ile cerrahi yapılan yere uyan bölgede 10x7 cm nüks semisolid kitle lezyonu izlenmiştir. Bu olgu sarkom tanılı hastalarda kısa süre içinde nüks görülebileceğini göstermesi açısından örnek bir olgudur.

Rapid recurrence of undifferentiated uterine sarcoma after surgery

Uterine sarcoma is a tumor accounting for only 1% of female genital tract malignancies and between 3% and 7% of uterine tumors. Although a high percentage of patients are diagnosed in the early stages, the survival rates are low. The patients usually present with abnormal vaginal bleeding, abdominal discomfort and pelvic masses. Uterine sarcomas are rapidly progressive tumors. Regional recurrence and distant metastasis are high. About 34-64% patients were reported with relapses. The majority of relapses occur within the first two years. In this case a 52 year old postmenopausal woman was admitted to our hospital with complaint of abdominal pain. MRI (magnetic resonance imaging) of the lower abdomen showed the mass 15 x 11 cm in size arising from the fundus of uteri and was evaluated as a degenerate leiomyoma and a total abdominal hysterectomy and left salpyngoophorectomy were performed. The pathology report showed that it was an undifferentiated uterine sarcoma. The low abdominopelvic CT (computed tomography) was performed on the 25th day after surgery and a 10 x 7 cm semisolid mass recurrence in the surgical region was observed. This case study report is an example to show that patients diagnosed with uterine sarcoma have a high risk of recurrence.

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