Kliniğimizde Tedavi Edilen Dermoid Kist Olgularının Analizi

GİRİŞ ve AMAÇ: Bu çalışmanın amacı kliniğimizde opere edilip patoloji sonucunda dermoid kist tespit edilen hastaların retrospektif olarak klinik özelliklerini, patolojik bulgularını ve operatif yaklaşım şekillerini değerlendirmektir. YÖNTEM ve GEREÇLER: 1 Ocak 2009 ile 1 Temmuz 2019 tarihleri arasında opere edilen 105 dermoid kist olgusunun verileri retrospektif olarak analiz edildi. BULGULAR: Hastaların ortalama yaşı 35,21±12,88 olarak tespit edildi. En sık başvuru semptomu olarak karın ağrısı (%40) saptandı. Hastaların %45,71’i asemptomatik idi. Hastaların %16,19’u postmenopozal dönemde tespit edilmiş olup altı (%5,71) hastada gebelik durumu mevcuttu. Ultrasonografide ortalama dermoid kist çapı 6,18±3,22 cm olarak bulundu ve yedi (%6,66) hastada bilateral olarak tespit edildi. Seksen beş (%80,95) hastaya laparatomi uygulanırken, geri kalan 20 (%19,05) hastaya laparoskopik cerrahi uygulandı. Hastalardan beşinde (%4,76) adneksiyal torsiyon tespit edildi. Serum Ca125 ortanca değeri 14,85 U/ml (minmax: 1,20-100,60 U/ml), Ca19-9 ortanca değeri 10,90 U/ml (min-max: 0,8-1993 U/ml) bulundu. Tümör belirteçleri normalin üstünde saptanan hiçbir hastada maligniteye rastlanılmadı. TARTIŞMA ve SONUÇ: Dermoid kistler reprodüktif dönemde sık görülen over tümörleridir. Ultrasonografi ile genellikle tanı konulabilmektedir. Dermoid kist tanısı için spesifik tümör belirteci bulunmamaktadır. Daha çok üreme döneminde görüldüklerinden over koruyucu cerrahi yaklaşımlar tercih edilmelidir. Fertilitesini tamamlamış ileri yaş hastalarda ooferektomi bir seçenek olarak düşünülmelidir.

Analysis of Dermoid Cyst Cases Treated in Our Clinic

INTRODUCTION: The aim of this study is to evaluate retrospectively the clinical property, pathology results and operative approach in patients who were operated in our clinic and whom pathology results were reported as dermoid cyst. METHODS: The data of 105 patients who were diagnosed with dermoid cyst and operated between January 1, 2009 - July 1, 2019 was analysed. RESULTS: The mean age of the patients was determined as 35,21±12,88. The most common symptom was abdominal pain (40%). 45.71% of the patients were asymptomatic. 16.19% of the patients were in postmenopausal period and in six patients (5.71%) pregnancy was detected. In ultrasonografic evaluation the mean diameter of the dermoid cyst was 6,18±3,22 cm and dermoid cyst was bilateral in seven patients (6,66%). Laparotomy was perfomed in 85 (80,95%) patients. For the remaining 20 (19,05%) patients, laporoscopy was perfomed. Adnexal torsion was diagnosed in five (4,76%) patients. The median value of Ca125 was 14,85 U/ml (min-max: 1,20-100,60 U/ml), and the median value of Ca 19-9 was 10,90 U/ml (minmax: 0,8-1993 U/ml). Malignancy was not detected in any patient with high levels of tumor markers. DISCUSSION AND CONCLUSION: Dermoid cysts are one of the most common ovarian tumors of the reproductive age. The diagnosis was generally made by ultrasonographic evaluation. There are no spesific tumor markers for dermoid cyst diagnosis. Because dermoid cysts mostly seen in reproductive age women, ovarian preserving surgery must be preferred. Oopherectomy should be considered in elderly patients with no fertility concern.

___

  • 1. Koonings PP, Campbell K, Mishell DR Jr, Grimes DA. Relative frequency of primary ovarian neoplasms: a 10-year review. Obstet Gynecol 1989; 74: 921-6.
  • 2. Peterson WF, Prevost EC, Edmunds FT, Handley JM, Morris FK. Benign cystic teratoma of the ovary: a clinico-statistical study of 1007 cases with review of the literature. Am J Obstet Gynecol 1957;72:1094.
  • 3. Momtahen AJ, Zawin J. Mature ovarian cystic teratoma (dermoid cyst). Ultrasound Q 2012;28:175- 177.
  • 4. Şahin, H., Akdoğan, A. I., Ayaz, D., Karadeniz, T., & Sancı, M. (2019). Utility of the “floating ball sign” in diagnosis of ovarian cystic teratoma. Turkish journal of obstetrics and gynecology, 16(2), 118.
  • 5. Steinberg W. The clinical utility of the CA 19- 9 tumor-associated antigen. Am J Gastroenterol 1990;85(4):350-5.
  • 6. Nezhat, C. R., Kalyoncu, S., Nezhat, C. H., Johnson, E., Berlanda, N., & Nezhat, F. (1999). Laparoscopic management of ovarian dermoid cysts: ten years' experience. JSLS: Journal of the Society of Laparoendoscopic Surgeons, 3(3), 179.
  • 7. Chiang AJ, Victor La, Peng J, Yu KJ, Teng NNH (2011) Squamous cell carcinoma arising from mature cystic teratoma of the ovary. Int J Gynecol Can 21(13):466–474.
  • 8. Polat, M., Incebiyik, A., Sanvedi, I., Senol, T., Sentürk, M. B., Özkaya, E., & Karateke, A. (2016). Dermoid Kist Nedeniyle Tedavi Edilen 114 Olgunun Retrospektif Analizi/Retrospective Analysis of 114 Cases Treated for Dermoid Cyst. Dicle Tip Dergisi, 43(2), 256.
  • 9. Aybar, M. D., Barut, A. Y., Öztürk, A., & Demirci, İ. (2010). Matür Kistik Teratomların Görüntüleme Özellikleri: US, BT, MRG Bulguları..
  • 10. Guinet, C., Buy, J. N., Ghossain, M. A., Malbec, L., Hugol, D., Truc, J. B., et al. (1993). Fat suppression techniques in MR imaging of mature ovarian teratomas: comparison with CT. European journal of radiology, 17(2), 117-121.
  • 11. Sah, S. Prasad, Kavita Verma, and Sudha Rani. "Neurogenic cyst of ovary: an unusual massive monodermal teratoma." Journal of Obstetrics and Gynaecology Research 27.1 (2001): 21-25.
  • 12. Walid, Mohammad Sami, and Mark G. Boddy. "Bilateral dermoid cysts of the ovary in a pregnant woman: case report and review of the literature." Archives of gynecology and obstetrics 279.2 (2009): 105.
  • 13. Var, T., Tonguc, E. A., Ugur, M., Altinbas, S., & Tokmak, A. (2012). Tumor markers panel and tumor size of ovarian dermoid tumors in reproductive age. Bratisl Lek Listy, 113(2), 95-8.
  • 14. Güzin, K., Karaalp, E., Gürgen, O., Süer, N., Öğütçüoğlu, B., & Örgül, G. (2012). Ovaryan matür kistik teratom (dermoid kist) olgularında preoperatif tümör belirteçleri ve bu belirteçlerin ovaryan matür kistik teratomun boyutu ile korelasyonu. Journal of Clinical Obstetrics & Gynecology, 22(4), 216-219.
  • 15. Artunc Ulkumen, B., Goker, A., Pala, H. G., & Ordu, S. (2013). Abnormal elevated CA 19-9 in the dermoid cyst: a sign of the ovarian torsion?. Case reports in obstetrics and gynecology, 2013.
  • 16. Nanayakkara, S., Ali, S., & Gilmour, K. (2007). Increased serum carcinomic antigen 19-9 (CA 19-9) in a dermoid cyst. Journal of obstetrics and gynaecology: the journal of the Institute of Obstetrics and Gynaecology, 27(1), 96-7.
  • 17. Yüksel, M. A., Abalı, R., Aras, Ö., Temel, İ., Ünal, F., Boran, A. B. et al.. (2011). Evaluation of CA 19-9 Levels in Ovarian Dermoid Cysts. Turkiye Klinikleri Journal of Gnynecology and Obstetrics, 21(3), 190-4.
  • 18. Yesilyurt, H., Seckin, B., Aktulay, A., & Ozyer, S. (2018). Age-stratified analysis of tumor markers and tumor characteristics in adolescents and young women with mature cystic teratoma. Journal of the Chinese Medical Association, 81(6), 499-504.
  • 19. Kawai, M., Kano, T., Kikkawa, F., Morikawa, Y., Oguchi, H., Nakashima, N. et al. (1992). Seven tumor markers in benign and malignant germ cell tumors of the ovary. Gynecologic oncology, 45(3), 248-253.
  • 20. Koçak, M., Dilbaz, B., Ozturk, N., Dede, S., Altay, M., Dilbaz, S., & Haberal, A. (2004). Laparoscopic management of ovarian dermoid cysts: a review of 47 cases. Annals of Saudi medicine, 24(5), 357-360.
  • 21. Fossey, S. J., and J. N. L. Simson. "Sclerosing encapsulating peritonitis secondary to dermoid cyst rupture: a case report." The Annals of The Royal College of Surgeons of England 93.5 (2011): e39- e40.
  • 22. Clement, D., Barranger, E., Benchimol, Y., & Uzan, S. (2003). Chemical peritonitis: a rare complication of an iatrogenic ovarian dermoid cyst rupture. Surgical endoscopy, 17(4), 658-658..
  • 23. Ferrari, M. M., Mezzopane, R., Bulfoni, A., Grijuela, B., Carminati, R., Ferrazzi, E. et al. (2003). Surgical treatment of ovarian dermoid cysts: a comparison between laparoscopic and vaginal removal. European Journal of Obstetrics & Gynecology and Reproductive Biology, 109(1), 88- 91.
  • 24. Hackethal, A., Brueggmann, D., Bohlmann, M. K., Franke, F. E., Tinneberg, H. R., & Münstedt, K. (2008). Squamous-cell carcinoma in mature cystic teratoma of the ovary: systematic review and analysis of published data. The lancet oncology, 9(12), 1173-1180.
Kocaeli Tıp Dergisi-Cover
  • ISSN: 2147-0758
  • Başlangıç: 2012
  • Yayıncı: -
Sayıdaki Diğer Makaleler

Kronik Obstrüktif Akciğer Hastalığı Fenotiplerine Göre Inflamatuar Hücrelerin Değerlendirilmesi

Nalan OGAN, Ersin GÜNAY, Eylem Evrim AKPINAR, Esen SAYIN GÜLENSOY, Aycan YÜKSEL

Role of p-Coumaric Acid in Alleviating of The Intestinal Ischemia/Reperfusion Injury

Ayhan TANYELİ, Fazile Nur EKİNCİ AKDEMİR, Ersen ERASLAN, Mustafa Can GÜLER, Saime ÖZBEK SEBİN, İlhami GÜLÇİN

Endobronşiyal Ultrasonografi Transbronşiyal İğne Aspirasyonun’da İ-gel Kullanımının Etkinliğinin Değerlendirilmesi

Jülide ERGİL, Fatma KAVAK AKELMA, Savas ALTINSOY, Mukaddes Tuğba ARSLAN, Ceyda ÖZHAN CAPARLAR, Aras METİN

Çocuklarda Overyan Kitle Patolojileri ve Tedavi Yaklaşımımız; 42 Olguluk Seri

Hayrünisa ESEN KAHRAMAN, Mustafa Alper AKAY

Tıkayıcı Uyku Apne Sendromlu Hastalarda Boyun ve Bel Çevresi Arteriyel İntima Media Kalınlığının Bir Göstergesi Olabilir Mi?

Orhan GÖRGÜLÜ, Feride Fatma GÖRGÜLÜ

Epicardial Adipose Tissue Thickness and Its Relationship With The Pathophysiology of Saphenous Vein Graft Disease

Mustafa DOĞUŞ, FETHİ YAVUZ, Mehmet KÜÇÜKOSMANOĞLU, Arafat YILDIRIM, Salih KILIÇ

Pulmonary Artery Systolic Pressure and Right Sided Heart Failure Symptoms: a Predictor for Progression of Iron Deficiency to Iron Deficiency Anemia in Heart Failure Patients

Onur ARGAN, Özge ÖZGÜN, Serdar BOZYEL, Dilek URAL, Güliz KOZDAĞ, Ayşen Ağaçdiken AĞIR, Eyüp AVCI, Ahmet DOLAPOĞLU

Can The Circumferences of Neck and Waist Be As a Predictor of Arterial İntima Media Thickness in The Patients with Obstructive Sleep Apnea Syndrome?

Feride Fatma GÖRGÜLÜ, Ahmet Orhan GÖRGÜLÜ

Gastrostomi Tüpü Yerleştirilen Çocuklarda Perkütan Endoskopik Gastrostomi ve Açık Gastrostominin Güvenlik Profillerinin Karşılaştırılması

Ziya SALİHOĞLU, Osman ESEN, Gülseren YILMAZ, Günsel KUTLUK

The Effects of Grading Scales Used in Patients with Aneurysmal Subarachnoid Hemorrhage on Critical Care Outcomes

Arzu YILDIRIM AR, Tamer BAYRAM, Güldem TURAN