İLHAN ÇİFTCİ, Doğan KÖSE, Yavuz KÖKSAL, ENGİN GÜNEL

Çocukluk çağında gonad tümörleri

Giriş: Testis ve over tümörleri nadir görülen tümörlerdir ancak çocuklarda sıklığı yetişkinlere oranla daha yüksektir. İki taraflı da görülebilirler ancak sağ tarafı tercih ederler. Dördüncü dekatta pik yapmalarına rağmen her yaşta görülebilirler. Ergen ve çocuklarda en sık rastlanan genital neoplazma ise germ hücreli tümörlerdir. Akciğer, meme, kolon ve pankreas kanserlerinden sonra ölümlerin en sık nedenidir. Metod: Bu çalışmamızda retrospektif olarak Çocuk Onkoloji ve Çocuk Cerrahisi Kliniklerine son yedi yılda gonadal kitle nedeni ile başvuran hastaların epidemiyolojik ve klinik özellikleri gözden geçirilmiştir. Sonuç: Gonadal tümör teşhisi erkeklerde oldukça kolaydır. Dikkatli fizik muayene ile testiste kitle tespit edilebilir, hidrosel gibi, testiste kitle yapan hastalıklardan ayırt edil- melidir. Kızlarda şikâyetler belirsiz olduğu için teşhis genellikle kitle etkisi nedeni ile konulmaktadır. Bu nedenle yaş olarak daha geç tanı almaktadırlar. Kliniğe üriner sistem semptomları yada kabızlık ile gelen hastalarda mutlaka sorgulama ve fizik muayene dikkatle yapılmalı, gonadal tümörler unutulmamalıdır.

Gonadal tumors in childhood

Indroduction:Testis and ovary tumors are rare tumors, but their incidence in child population is high. They can be seen bilaterally but they prefer to right side. Although the peak in the fourth decade of life they occur all ages. The most common genital neoplasm in children and adolescent are Germ Cell tumors. They are the most common cause of death after the lung, breast, colon and pancreatic cancer. Method:In this retrospective study, epidemiological and clinical characteristics of patients with gonadal mass were reviewed who are applicant Pediatric Oncology and Pediatric Surgery Clinics in last seven year. Results:Gonadal tumor diagnosed in boys is very easy. Testicular mass can be determined by careful physical examination. Testicular mass must be distinguished from the such as hydrocele. In females, the diagnosis is uncertain complaints are being usually due to mass effect. For this reason, later diagnose as well. Clinic patients presenting with constipation or urinary tract symptoms, must be done careful questioning and physical examination, gonadal tumors should not be forgotten.

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1. Deotra A, Mathur DR, Vyas MC. A 18 years study of testicular tumours in Jodhpur, Western Rajasthan. Postgrad Med J 1994;40:68- 70.
2. Che M, Tamboli P, Ro JY, Park DS, Ro JS, Amato RJ, Ayala AG. Bilateral testicular germ cell tumors: twenty-year experience at M. D. Anderson Cancer Center. Cancer. 2002 15;95(6):1228-33.
3. Bahrami A, Ro JY, Ayala AG. An overview of testicular germ cell tumors. Arch Pathol Lab Med 2006;131:1267-1280.
4. Akdogan B, Divrik RT, Tombul T, Yazici S, Tasar C, Zorlu F, Ozen H. Bilateral testicular germ cell tumors in Turkey: increase in incidence in last decade and evaluation of risk factors in 30 patients. J Urol. 2007 Jul;178(1):129-33; discussion 133.
5. Walschaerts M, Muller A, Auger J, Bujan L, Guérin JF, Le Lannou D, Clavert A, Spira A, Jouannet P, Thonneau P. Environmental, occupational and familial risks for testicular cancer: a hospital-based case-control study. Int J Androl. 2007 Aug;30(4):222-9.
6. Cartault A, Caula-Legriel S, Baunin C, Le Mandat A, Lemasson F, Galinier P, Pienkowski C. Ovarian masses in adolescent girls. Endocr Dev. 2012;22:194-207.
7. Parham G, Phillips JL, Hicks ML, Andrews N, Jones WB, Shingleton HM, Menck HR. The National Cancer Data Base report on malignant epithelial ovarian carcinoma in African-American women. Cancer. 1997 Aug 15;80(4):816-26.
8. Vogelzang NJ, Scardino PT, Shipley WU, Debruyne FMJ, Linehan WM. Comprehensive Textbook of Genitourinary Oncology, 3. Lippincott Williams & Wilkins 2006;574-5.
9. Eble JN, Sauter G, Epstein JI, Sesterhenn IA. WHO Classification of Tumours. Pathology and Genetics of Tumors of the Urinary System and Male Genital Organs. IARC Press, Lyon, 2004, pp.217-277.
10. Gatti JM, Stephenson R: Staging of testis cancer. Urol Clin North Am. 1998;25(3): 397-403.
11. Wein AJ, Kavaoussi LR, Novick AC, Partin AW, Peters CA. Campbell-Walsh Urology. 9. Philadelphia, Saunders, 2007; 893-935.
12. Helikson ME. Teratoma 101. In: Ziegler MM ed. Operative Pediatric Surgery. USA: Mc Graw-Hill Companies, 2003; 1198-9.
13. Koonings PP, Campbell K, Misshell Dr Jr, Grimes DA. Relative frequency of primary ovarian neoplasms: A 10-year review. Obstet Gynecol 1989;74:921-926.
14. Kocak M, Beydilli G, Dilbaz S, Tasci Y, Haberal A. Adnexal masses in adolescent girls with pelvic pain: report on 63 patients. Gynecol Surg 2008; 5: 203-7.
15. Davis AJ. Pediatric and adolescent gynecology. In: Gibbs RS ed(s). Danforth's Obstetrics and Gynecology. 10th ed. Philadelphia: Lippincott Williams & Wilkins, 2008: 555-66.
16. Herzog C. Gonadal and Germ cell Tumors. In: Behrman RE ed (s). Nelson Textbook of Pediatrics. 17th Ed. Philadelphia: Saunders, 2004; 1723-4.
17. Muram D. Corbacıoğlu A cev (ed)s. Pediatrik ve Adolesan Jinekoloji. In: Decherney AH, ed. " Current Diagnosis and Treatment" Serisi. Güncel Obstetrik ve Jinekoloji Tanı ve Tedavi. 10th ed. Ankara: Guneş Tıp Kitabevleri, 2010: 540-69.
18. Tzadik M, Purcell K, Wheeler JE. Onan A cev ed. Over ve tüplerin benign hastalıkları. In: Decherney AH (eds). " Current Diagnosis and Treatment" Serisi. Güncel Obstetrik ve Jinekoloji Tanı ve Tedavi. 10th ed. Ankara: Guneş Tıp Kitabevleri, 2010; 654-61.