Hasan GÖKÇE, Serhat TOPRAK, Tümay ÖZGÜR, Esin DOĞAN, Mehmet YALDIZ, Seçkin AKKÜÇÜK, Raif ÖZDEN, İbrahim YETİM, Aydıner KALACI, Muhyittin TEMİZ

YÜZEYSEL VE DERİN YERLEŞİMLİ FİBROMATOZİSLER: BENZER HİSTOMORFOLOJİK GÖRÜNÜM ANCAK FARKLI BİYOLOJİK DAVRANIŞ

Amaç: Fibromatozisler yüzeysel ya da derinyerleşimli olabilen ve çoğunlukla cerrahi eksizyon iletedavi edilen, lokal infiltratif yumuşak dokutümörleridir. Özellikle derin yerleşimlifibromatozislerin cerrahi ile lokal kontrolü sorun teşkiletmektedir. Bu çalışmada laboratuarımızdafibromatozis tanısı alan yüzeysel ve derin yerleşimliolguların klinik, histopatolojik ve immün boyanmaözellikleri karşılaştırılmıştır.Gereç ve yöntemler: Ocak 2005 ile Aralık 2013tarihleri arasında fibromatozis tanısı alan 12 olguçalışmaya alındı. Hastalarda yaş, cinsiyet, tümöryerleşimi, tümör boyutu, tümörlerin histomorfolojikve immün boyanma özellikleri karşılaştırıldı.İstatistiksel analizlerde Mann–Whitney U ve Chi-Square/Fisher's Exact testi kullanıldı. p < 0.05sonuçlar anlamlı kabul edildi.Bulgular: Fibromatozis tanısı alan olguların 4'üyüzeysel, 8'i derin yerleşimli idi. Hastaların yaşı 18 ile72 arasında değişmekteydi (ortalama 62,5). Yüzeyselyerleşimli olguların hepsi erkek, derin yerleşimliolguların hepsi kadındı. Yüzeysel yerleşimlitümörlerde nüks izlenmezken derin yerleşimliolgulardan 3'ü (%37,5) nüksetmişti. Yüzeyselyerleşimli tümörlerin boyutu 1,5 cm ile 4,5 cmarasında değişmekteydi (ortalama 3,5 cm). Derinyerleşimli tümörlerin boyutu 1,5 cm ile 15 cmarasında değişmekteydi (ortalama 9 cm). İstatistikselanalizde tümör lokalizasyonu ile cinsiyet (p= 0,002)ve tümör boyutu (p= 0,042) arasında anlamlı ilişkisaptandı. Tümör yerleşim yeri ile yaş (p= 0,173), nüksoranı (p= 0,491), desmin (p=0,491), düz kas aktin (p=0,091), S-100 protein (p=0,515), Ki-67 (p= 0,236)immün boyaları ve Ki-67 proliferasyon indeksi(p=0,248) arasında anlamlı ilişki görülmedi.Sonuç: Yüzeysel ve derin yerleşimli fibromatozislerinhistomorfolojik görünümü ve immün boyanmaözellikleri birbirine benzerdir. Ancak klinik özelliklerive biyolojik davranışları açısından bu iki antitebirbirinden farklı gibi gözükmektedir.

Anahtar Kelimeler:

Yumuşak doku, fibromatozis, desmoid tümör

Superficial and Deep Situated Fibromatoses: Similar Histomorphologic Appearance but Different Biological Behavior

Aim: Fibromatoses are a locally infiltrative soft tissue tumors being situated superficial or deep tissues and usually treated by surgical excision. The surgical local control of these tumors, especially ones arising from deep tissues, remains a significant problem. On this study, we aimed to investigate the clinical, histopathological and immune staining features of superficial and deep fibromatoses diagnosed our laboratory. Material and methods: Consecutive twelve cases diagnosed as fibromatoses between January 2005 to December 2013 were included to the study. Patients' ages, sex, the localization of tumor, the tumor size, histomorphological features and immune staining profiles of tumors were investigated. Statistical analyses were performed using Mann–Whitney U and Chi-Square/Fisher's Exact test. Results were considered to be significant at p < 0.05. Results: Four cases were superficial-seated, and 8 cases were deep-seated fibromatoses. The age of patients ranged from 18 to 72 (mean 62.5). All of superficial fibromatoses were male. All of deep fibromatoses were female. No recurrence was observed on superficial tumors. Three (37.5%) of deep-seated tumors had recurrent. The size of superficial tumors ranged from 1.5 cm to 4.5 cm (mean: 3.5 cm). The size of deep-seated tumors ranged from 1.5 cm to 15 cm (mean: 9 cm). There was no statistically significant difference between the two groups, in terms of the patients' age (p= 0.173), the recurrence rate (p= 0.491), Ki-67 proliferation index (p = 0.248) and immune staining for desmin (p= 0.491), smooth muscle actin (p= 0.091), S-100 protein (p= 0.515), Ki-67 (p = 0.236). Statistically, a significant correlation was observed between the two groups, in terms of the gender (p= 0.002) and the tumor size (p= 0.042). Conclusion: The histomorphological appearance and immune staining characteristics of superficial and deep-seated fibromatoses are similar. However, the clinical features and in terms of biological behavior of these two entities seems to be different from each other

Keywords:

Soft tissue, fibromatoses, desmoid tumor,

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