SERVİKS SKUAMÖZ HÜCRELİ KANSERİN ÖVERE METASTAZI VE TRAKELEKTOMİ İŞLEMİNİN LİTERATÜR EŞLİĞİNDE DEĞERLENDİRİLMESİ

Amaç: Kliniğimizde 6 yıl önce uygulamış olduğumuz trakelektomi operasyonunun uzun dönem takip sonuçlarını literatür eşliğinde değerlendirmeyi ve nadir görülen bir vaka olan serviksin övere sküamöz hücreli metastaz durumunun bildirilmesi amaçlanmıştır. Olgu: Hastanemizde 6 yıl önce evre 1A2 serviks kanseri nedeniyle trakelektomi yapılan hasta operasyondan 7 ay sonrasında servikal stenoz nedeniyle ikinci kez operasyona alınmış ve dilatasyon & drenaj işlemleri uygulanmıştır. Postoperatif uzun dönem takiplerinde ise 1 yıl sonrasında 3-4 cm’lik adneksiyal kitle gelişmesi ve malignite düşünülmesi nedeniyle üçüncü kez operasyon uygulanmıştır. Frozen sonucunda malignite saptanan hastaya total histerektomi ve bilateral salpingooferektomi yapılmıştır. Kesin patoloji sonucunda serviksin övere skuamöz hücreli tümör metastazı olarak belirlenmiştir. Hastanın 6 yıl sonrasında şuan nüks tümörü veya başka bir patolojisi bulunmamaktadır. Sonuç: Radikal trakelektomi günümüze kadar yapılan araştırmalar sonucunda etkinliğini ve uygun bir seçenek olduğunu ispatlamaktadır. Bu nedenle uygun hasta grubunda tanı sağlandıktan sonra bu tekniğin düşünülmesi ve deneyimli bir merkezde uygulanması en doğru yaklaşım olacaktır. Serviksin skuamöz hücreli kanserlerinin nadiren de olsa överlere metastaz yapabileceği unutulmamalı, hastanın takiplerinde bu durum göz ardı edilmemelidir.

Anahtar Kelimeler:

Serviks kanseri, konservatif yaklaşım, fertilite koruyucu cerrahi.

OVARIAN METASTASIS OF CERVIX SQUAMOUS CELL CARCINOMA AND EVALUATION OF THE LITERATURE ABOUT TRACHELECTOMY PROCESS

Objective: Evaluation of the literature about the long term follow-up of trachelectomy operation and to notify the rare situation of cervical squamous cell carcinoma metastasis to the ovaries. Case: We have done a trachelectomy operation 6 years ago for stage 1A2 cervix carcinoma. 7 months after the operation a cervical stenosis was diagnosed and a second operation was done for dilatation-drainage. 1 year later a 3-4 cm adnexal mass occurred. And it had malignancy suspicion. The patient had the third operation for the adnexal mass and in the frozen examination malignancy was detected. She had total abdominal hysterectomy and bilateral salpingoopherectomy because of that. After the exact pathologic examinations cervix squamous cell carcinoma metastasis to the ovaries was seen. After 6 years she does not have any recurrence or other any pathology. Conclusion: As a result of the researches radical trachelectomy proves that it is an effective and appropriate option. Therefore it must be considered in suitable patients and implemented in experienced centers will be the right approach. And it should be noted that cervix squamous cell carcinoma can make metastasis to the ovaries and patient’s follow-ups should not be ignored in this case.

Keywords:

Cervical cancer, Conservative approach, Fertility-sparing surgery.,

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