Ulaş ALABALIK, Elif AĞAÇAYAK, Uğur FIRAT, Ayşe Nur KELEŞ, Gül TÜRKCÜ, Zuhat URAKÇI

Servikal adenoid bazal karsinom: Olgu sunumu

Adenoid bazal karsinom serviks kanserlerinin %1'den azını oluşturan nadir bir tümördür. Çoğunlukla postmenapozal kadınlarda görülür. Makroskopik olarak bu tümörler genellikle büyük boyutlara ulaşmazlar. Mikroskopik olarak adenoid bazal karsinomlar palizat yapıları ile çevrili adalar yapan, üniform, yuvarlak, bazaloid hücrelerden oluşur. İmmünohistokimyasal olarak CAM 5.2, CK7, EMA ve CEA eksprese ederler. Birimimize gönderilen TAH+BSO materyalinin değerlendirmesinde uterus arka duvarı yerleşimli, 4x3x2 cm boyutlarında endoservikal yüzeyi ülsere kitle saptandı. Kitleden hazırlanan kesitlerin mikroskopik incelemesinde, şiddetli displazinin eşlik ettiği yüzey epiteli altında bazaloid hücrelerden oluşan tümöral yapı izlendi. Tümörün genelde periferde palizatlanma gösteren yuvalanmalar ve adacıklar tarzında gelişim sergilediği gözlendi. Tümör hücreleri hafif-orta derecede pleomorfizm ve atipi ile karakterize olup mitotik indeks düşük saptandı. İmmünohistokimyasal çalışmada CEA ve CK7 pozitif, HMWCK, vimentin, CD34 ve HPV18 negatif boyandı. Adenoid bazal karsinom vakaları tipik olarak lokal rekürrens, metastaz ve ölüme yol açmayan çok iyi prognoza sahip tümörlerdir. Hastamız 48. ayını doldurmuş olup herhangi bir nüks ve metastaz izlenmemiştir.

Cervical adenoid basal carcinoma: Case report

Adenoid basal carcinomas are rare tumors that accounts for less than 1% of all cervical cancers. Generally they are seen in postmenopausal women. Macroscopically these tumors do not reach large sizes. Microscopically adenoid basal carcinomas are composed of uniform, round, basaloid cells that form nests surrounded by palisade formations. These tumors express CAM 5.2, CK7, EMA, and CEA immunohistochemically. In evaluation of the material referred to our unit, an ulcerated mass lesion that is located on uterine posterior wall is determined. On microscopic examination of sections prepared from the mass, under the surface epithelium accompanied by severe dysplasia, a tumoral formation composed of basaloid cells is observed. It is seen that the tumor demonstrate configurations of nests and islets which comprise generally peripheral palisading. When the tumoral cells are characterized by mild to moderate pleomorphism and atypia, the mitotic index is detected low. In immunohistochemical studies, the tumoral cells are positively stained with CEA and CK7, and negatively stained with HMWCK, vimentin, CD34, and HPV18. Adenoid basal carcinoma cases typically do not manifest with local recurrence or metastasis and have very good prognosis. Our case has filled 48 months after the diagnosis and any local recurrence or metastasis has not been observed.

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