Gebeliğin 3. trimesterinde over torsiyonu: Vaka takdimi Ovarian torsion in 3. trimester of pregnancy: Case report

Otuz altı yaşında, gebeliğinin 35. haftasında olan bir hasta merkezimize ciddi sağ alt kadran ağrısı ile başvurdu. Torsiyone 12 cm sağ over kisti tanısı koyuldu. Hastaya epidural anestezi altında laparatomi uygulandı ve kist başa- rılı şekilde intakt olarak çıkarıldı. Bebek sezaryen ile doğur- tuldu. Histopatolojik incelemede; İntestinal tip Borderline müsinöz tümör bulundu. Postoperatif 4.ayında cerrahi evreleme uygulandı. Hasta klinik olarak takip edildi. Antepartum cerrahi müdahale güvenli kabul edildiği halde, abdominal cerrahi hamile bir kadın ve karnındaki fetus için bazı riskler taşır. Bu yüzden yönetim seçimi adneksiyal kitlenin karakteri ve gebelik yaşına göre karar verilmelidir.

A 36-year-old, 35th week of pregnancy woman was admitted to our center with severe right lower quadrant pain. The diagnosis of torsion of 12 cm right ovarian cyst was made. Patient underwent laparotomy under epidural anesthesia and the cyst was successfully removed intact. Fetus was delivered by cesarean section. Histopathological examination found intestinal-type borderline mucinous tumor. 4 months postoperatively, patient underwent surgical staging. Patient were followed-up clinically. Abdominal surgery carries some risks for the fetus of a pregnant woman although antepartum surgery has been considered safe. Management choice must be selected according to gestational age and adnexal mass character.

Kaynakça

1. Leiserowitz G. Managing ovarian masses during pregnancy. Obstet Gynecol Surv 2006;61(7):463-70.

2. Hoover K, Jenkins TR. Evaluation and management of adnexal mass in pregnancy. Am J Obstet Gynecol 2011;205(2):97-102.

3. Huchon C, Fauconnier A. Adnexal torsion: a literature review. Eur J Obstet Gynecol Reprod Biol 2010;150(1):8-12.

4. Sommerville M, Grimes DA, Koonings PP, et al. Ovarian neoplasms and the risk of adnexal torsion. Am J Obstet Gynecol 1991;164(2):577–8.

5. Kumari I, Kaur S, Mohan H, et al. Adnexal masses in pregnancy: a 5-year review. Aust N Z J Obstet Gynaecol 2006;46(1):52–4.

6. Taylor HC. Malignant and semi-malignant tumors of the ovary. Surg Gynecol Obstet 1929;48:204-30.

7. Classification and staging of malignant tumors in the female pelvis. Acta Obstet Gynecol Scand 1971;50(1):1-7.

8. Serov SF, Scully RE, Sobin LH. Histologic typing of ovarian. In: International classification and staging of tumors. Number 9, Geneva: World Health Organization 1973:37-8.

9. Huusom LD, Frederiksen K, Høgdall EV, et al. Association of reproductive factors, oral contraceptive use and selected lifestyle factors with the risk of ovarian borderline tumors: a Danish case- control study. Cancer Causes Control 2006;17(6):821-9.

10. Scully RE, Young RH, Clement PB. Tumors of the ovary, maldeveloped gonads, fallopian tube, and broad ligament. In: Atlas of tumor pathology. 3rd series, Washington: Armed Forces Institude of Patholog, 1998:Fascicle23.

11. Lee CH, Raman S, Sivanesaratnam V. Torsion of ovarian tumors: a clinicopathological study. Int J Gynaecol Obstet 1989;28(1):21-5.

Kaynak Göster