Muzaffer SANCI, Volkan KARATAŞLI, İlker ÇAKIR, Batuhan DEMİR, Orhan TEMEL, Mustafa BAĞCI, Selçuk ERKILINÇ, Mehmet GÖKÇÜ, Behzat CAN

Benign ve Malign Extra-Genital Over Kanseri Taklitçileri: 28 Olgunun Gözden Geçirilmesi

Giriş: Over kanseri ön tanısı ile opere edilen hastalarda genital sistem kaynaklı olmayan kitleleri bulunan olguları değerlendirmekGereç ve Yöntemler: 2013 ocak-2017 Ocak tarihleri arasında jinekolojik onkoloji cerrahisi kliniğinde opere edilen 770 over kanseri ön tanısı bulunan hastanın kayıtları incelendi. Over kanseri olmayan ancak pelvik ve abdominal kitlesi bulunan ve preoperatif dönemde over kanseri şüphesi bulunan 28 hastaya ulaşıldı. Hastaların dosyalarından yaş, tanı, tümör belirteçleri, görüntüleme bulguları, tümör boyutu, hastalığın evresi, takip süresi, toplam sağkalım, patolojik bulgular verileri toplandı.Bulgular: Over Kanseri ön tanısıyla opere edilen hastalardan sırasıyla 10 %35.7 hastada appendiks kanseri, 6 %21 hastada kolon ya da meme kanseri metastazı, 6 %21 hastada tüberküloz, 3 %10.7 hastada gastrointestinal stromal tümör GIST , 2 %7.1 hastada diffüz büyük B hücreli lenfoma, 1 %3.6 hastada mezotelyoma saptandı. Appendiks müsinöz tümör saptanan hastaların tamamına radikal appendektomi ve ileotransversostomi yapıldı. 5 Hastada psödomixoma peritonei saptandı ve psödomixoma saptanan 3 hastaya hipertermik intraperitoneal kemoterapi uygulandı. Appendiks musinöz karsinomu saptanan 2 hastada evre 1, 2 hastada evre 2 ve 5 hastada evre 4 tümör saptandı. Appendiks tümörü, Kolon/Meme Tümörü metastazı, mezotelyoma grupları arasında toplam sağkalım için istatistiksel farklılık saptanmadı.Sonuç: Over karsinomu ön tanısı ile opere edilen hastalarda tüberküloz, apendiks tümörü, kolon ve meme kanseri metastazı, lenfoma, KLL, GIST, mezotelyoma gibi genital sistem dışından kaynaklanan malign ve benign hastalıklar akılda bulundurulmalı klinik şüphe durumunda bu durumlara yönelik inceleme yapılmalıdır.

Anahtar Kelimeler:

Over kanseri, taklit eden durumlar, ayırıcı tanı

Benign And Malign Extra-Genital Ovarian Cancer Mimickers: A Review Of 28 Cases

Aim: To evaluate clinical characteristics of the patients that underwent surgery for suspicious adnexal masses and diagnosed as extra-genital benign and milign diseases.Material And Methods: A total of 770 patients that had operated at gynecologic oncology department for a suspicious ovarian mass were investigated. Of the patients 28 were diagnosed as extra ovarian diseases presenting abdominal or pelvic mass. Collected data were age, diagnosis, tumor markers, imaging findings, tumor diameters, stage, time for follow up, overall survival, pathology results.Results: Final diagnosis of the patients that had a prediagnosis of ovarian cancer were as follows: 10 35,7% with appendix carcinoma, 6 21% with colon or breast cancer metastasis, 6 21% with tuberculosis, 3 10,7 with gastrointestinal stromal tumor GIST , 2 7,1% with diffuse large B cell lymphoma, 1 3,6% with peritoneal mesotelioma, 1 3,6 with chronic lymphocytic leukemia CLL . A radical appendectomy and ileotransversostomy was performed to all patients with appendix carcinoma. Patients with psoudomyxoma peritonei were treated with cytoreduction and 3 of them received hypertermic intraperitoneal chemotherapy HIPEC . The number of patients with appendix mucinous carcinoma in stage 1-2-4 were 2-2-4 respectively. There was no significant difference in overall survival in patients with appendix carcinoma, colon/breast cancer metastasis, mesotelioma.Conclusion: The possibility of tuberculosis, colon/breast cancer metastasis, CLL, diffuse large B cell lymphoma, GIST should be considered and a comprehensive work up for these conditions should be performed in patients that have prediagnosis of ovarian cancer.

Keywords:

Ovarian carcinoma, mimickers, differential diagnosis,

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