Nilgün YILDIRIM, Tülay ŞİMŞEK, Emine DÜNDAR

Ekstraoküler Kistik Tümörlerinde Klinik Tanı ve Tedavi Sonuçları

Ekstraoküler kistik tümörü olan olguların patoloji ve klinik bulgularla konulan tanıları, klinik özellikleri ile tedavi sonuçlarının değerlendirilmesi. Ekstraoküler kistik tümörü tanısı alan 85 olgu çalışmaya alındı. Olgular yaş, cinsiyet, klinik bulgular, tümörün yerleşimi, klinik ön tanı, tedavi, patolojik tanı ve prognoz açısından değerlendirildi. Seksen beş olguya ait 92 tümör retrospektif olarak değerlendirildi. Olguların 47’si (%55,3) kadın, 38’i (%44,7) erkek olup yaş ortalaması 26,8±5,2 yıl idi. 7 olguda tümörün iki taraflı olduğu saptandı. Olgularda, en sık başvurma nedeni gözde ağrısız şişlik olmasıydı. Diplopi ve egzoftalmus en sık mukosel olgularında saptandı. Kistler en sık alt iç kadranda (%35) yerleşmiş olup bunu sırası ile üst dış kadran (%27), üst iç kadran (%25) ve alt dış kadran (%13,5) izliyordu. Cerrahi tedavide bir olgunun 1 gözündeki tümör total olarak çıkartıldı. Dört olgu ise cerrahi tedavi uygulanmadan izleme alındı. Kitlelerin patolojik tanıları; 31’i epidermal dermoid kist, 7’si konjonktival dermoid kist, 37’si epidermal kist (18 primer kutaneöz, 15 primer konjonktival, 4 sekonder konjonktival) , 7’si sudoriferous kist, 5’İ kolobomatöz kist, 3’ü mukosel, 2’si lipodermoid idi. Alt iç kadranda en sık epidermal kistler, üst iç ve dış kadranda ise en sık dermoid kistler görüldü. Kistik tümörlerin %13’ünde klinik ve patolojik tanı arasında uyuşmazlık saptandı. Cerrahi yapılan konjonktiva dermoid kistli bir göz dışında diğerlerinde nüks görülmedi. Çalışmamızda, epidermal kistler ve dermoid kistler en sık görülen ekstraoküler kistik tümörü olup, klinik ön tanı ile patolojik tanı uyumu %87 olarak saptandı. Kistin tamamının çıkartılması ile kür sağlandığı görüldü.

Anahtar Kelimeler:

epidermoid kist orbita kistleri, dermoid, teratom

Clinical diagnosis and treatment results of extraocular cystic tumours

Evaluation of the diagnosis, clinical features and treatment results of cases diagnosed with extraocular cystic tumors based on pathological and clinical findings. Eighty-five patients diagnosed with extraocular cystic tumours were included in the study. Patients were evaluated in terms of age, sex, clinical findings, localization of the tumor, clinical diagnosis, pathological diagnosis, and treatment outcomes. Ninety-two eyes of 85 patients were evaluated retrospectively. There were 47 (%55.3) female and 38 (%44.7) male patients with a mean age of 26.8±5.2 years. Tumors were bilateral in 7 patients. The most common presenting sign was a painless swelling in the eye. Diplopia and proptosis were mostly observed in patients with mucocele. Cystic lesions were localized in inferomedial (%35) superolateral (%27), superomedial (%25), and inferolateral (%13.5) aspects of the orbit respectively. Tumoral mass completely excised by surgical treatment except in one patient. Four patients were followed without surgical treatment. Pathologic diagnoses were; epidermal dermoid cyst (31), conjunctival dermoid cyst (7), epidermal cyst (37; primary cutaneous (18), primary conjunctival (15), secondary conjunctival (4), sudoriferous cyst (7), colobomatous cyst (5), mucocele (3), an lipodermoid (2). The epidermal cyst was the most frequently seen cystic lesion in the lower inner quadrant. The dermoid cyst was the most frequently seen lesion in the upper inner and outer quadrants. A mismatch between clinical and pathological diagnosis was 13%. Recurrence was not observed except in one eye with a conjunctival dermoid cyst. Dermoid cysts and epidermal cysts were the most common cystic tumors of the extraocular tissues. Concordance between pathological and clinical diagnosis was found to be 87%. The cure was maintained by removing the cyst completely.

Keywords:

epidermoid kist orbita kistleri, dermoid, teratom,

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