Zeliha AKIŞ YILDIZ, Mehmet ARPACIK, Begum SİRİN, İlkay TOSUN, Cem YALÇINKAYA, Zekeriya İLCE

Çocuklarda Cerrahi Over Kitleleri: 11 Yıllık Deneyim

Amaç: Çocukluk çağı over kitlelerinin çoğunluğu benigndir. Ancak yetişkinlik döneminde görülen malign tümörlerde çocukluk çağında görülebilmektedir. Bu tümörlerel ilgili çocukluk çağına ait bir protokol hala yoktur. Bizde kliniğimizde opere edilen over kitleleri ile ilgi deneyimimizi paylaştık. Gereç ve Yöntemler: Hastanemizde 2010 ile 2020 yılları arasında over kitlesi nedeniyle opere edilen 0 ila 18 yaş arası olgular çalışmaya dahil edildi. Hastaların yaşları, ultrasonografi (USG) ve diğer yapılan görüntüleme yöntemlerinde kitlenin maksimum çapı ve yapısı, başvuru semptomları, tümör belirteçleri, operasyon verileri, patoloji sonuçları kaydedildi. Patolojiye göre 3 gruba ayrılarak demografik veriler karşılaştırıldı. Bulgular: Çalışmanın yapıldığı 11 yıllık süreçte 106 olguya over kitlesi nedeniyle 107 ameliyat yapılmıştır. Olguların yaşları 2 gün ile 17 yaş arasında değişmekle birlikte ortalaması 13.4±14.1’dir. Bu ameliyatlardan 9 (%8.4)’ü malign (3’ü (%2.8) borderline), ve 44 (%41.1)’i benign neoplastik over kitlesi, 54 (50.5)’i nonneoplastik over kitlesiydi. Neoplastik over kitlesi nedeniyle yapılan 53 ameliyatta patoloji sonuçları; olgulardan 31 (%29)’u germ hücreli tümör, 19 (%17.8)’i epitelyal tümörler, 2 (%1.9)’u seks kord stromal tümör, 1 (%0.9) leomiyom olarak değerlendirildi. Sonuç: Çocukluk çağı over kitlelerinde multidisipliner yaklaşım unutulmamalıdır. Çocukluk çağında az görülen over tümörlerinde gerektiğinde yetişkin protokollerinden yararlanılırken, çok merkezli çalışmalarla seriler oluşturulmalı ve böylece konu ile ilgili çocuk protokolleri oluşturulmalıdır.

Anahtar Kelimeler:

Çocuk, Kitleler, Over, Cerrahi

Surgical Ovary Masses in Children: A Single Center Experience of 11 Years

Objective: The majority of childhood ovarian masses are benign. However, malignant tumors encountered in adulthood may also be seen in childhood. There is still no ovarian tumor management protocol for children. We shared our experiences with ovarian mass cases operated in our clinic. Material and Methods: Patients aged 0-18 years and had surgery in our hospital between 2010 and 2020 due to ovarian masses were included in the study. The ages of the patients, the maximum diameter and structure of the mass on ultrasonography (USG) and other imaging modalities, symptoms on presentation, tumor markers, operation data, and histopathology results were recorded. The patients were divided into three groups in relation with tumor histopathology, and the demographic data were compared among groups. Results: In 11-year period, 107 surgical operations were performed on 106 patients due to ovarian masses. The ages of the patients were between 2 days and 17 years, with a mean age of 13.4±14.1 years. Of the masses, 9 (8.4%) were malignant (3 (2.8%) borderline), 44 (41.1%) were benign, and 54 (50.5) were non-neoplastic. Histopathology results of 53 surgical operations performed for neoplastic ovarian masses were germ cell tumor in 31 (29%), epithelial tumor in 19 (17.8%), sex cord stromal tumor in 2 (1.9%), and leiomyoma 1 (0.9%) patient. Conclusion: Adult protocols should be used when necessary in rare childhood ovarian malignant tumors, and large multi-center patient series should be constituted in order to establish pediatric protocols related to the subject. A multidisciplinary approach is necessary in childhood ovarian masses.

Keywords:

Children, Masses, Ovary, Surgery,

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