Adnan ORHAN, İşıl KASAPOĞLU, Şeyda ARIK, Fatma ÖZ ATALAY, Kemal ÖZERKAN, Bilge ÇETİNKAYA DEMİR, Hamza Furkan ŞEN, Gürkan UNCU

Laparoskopik Matür Kistik Teratom Eksizyonu Sonrası Kistin Büyüklüğü ile İçerdiği Farklı Mezodermal ve Ektodermal Doku Komponentleri Arasındaki İlişki

Overin matür kistik teratomu (MKT) ikinci ve üçüncü dekattaki kadınların en sık görülen over tümörüdür. Hemen tamamı benign olan bu tümörlerin rüptür, torsiyon ve malignite gibi çeşitli komplikasyonları vardır. Her üç germ yaprağından da köken alabilen bu tümörlerde kemik, kıkırdak, diş gibi farklı germ yapraklarına ait dokular izlenebilir. Bu çalışmanın amacı laparoskopik MKT eksizyonu yaptığımız hastaların tümör içeriklerindeki doku farklılıklarını gözlemek ve bu dokuların MKT kist büyüklüğü ile olan ilişkisini araştırmaktır. Retrospektif olarak planlanan bu çalışmaya 01.01.2006 – 31.12.2018 tarihleri arasında bir üniversite hastanesinde laparoskopik MKT eksizyonu uygulanan hastalar alındı. Hastaların demografik özellikleri, MKT çapı, bilateralite oranı, lobülasyon, içeriğindeki kıl, diş, kemik dokusu varlığı ayrıntılı olarak incelendi. Çalışmaya 236 hasta alındı. 222 hastaya laparoskopik MKT kist eksizyonu uygulanmıştı. 14 hastada ise diğer laparoskopik operasyonlar sonrasında patoloji spesimeninde matür kistik teratom saptanmıştı. Bilateralite oranı %15,2 idi. 4-5 cm çapında 58, 5-6 cm çapında 78, 6-7 cm çapında 82, 7 cm’den büyük 54 MKT saptandı. MKT’un çapı arttıkça içerisinde kıl, diş veya kemik doku bulunma veya lobule olma ihtimali belirgin olarak artıyordu. İstatistiksel olarak bakıldığında özellikle 7 cm den büyük kistlerde her üç dokuyu da içerme ve lobülasyon olasılığı en yüksek anlam düzeyine ulaşıyordu. Sonuç olarak laparoskopik MKT eksizyonu yapılan olgularda kist boyutu ile içerdiği farklı germ yapraklarına ait doku komponentleri ve lobülasyon durumu doğru orantılıdır. Bu durum özellikle 7 cm ve üstü matür kistik teratomlarda daha belirgindir.

Anahtar Kelimeler:

Matür kistik teratom, Dermoid kist, Ektodermal komponent

The Relationship Between the Size and Ectodermal or Mesodermal Components in Laparoscopic Mature Cystic Teratoma Excisions

Mature cystic teratoma of the ovary (Dermoid cyst) is the most common ovarian tumor in women in the second and third decades. These tumors, all of which are benign, have various complications such as rupture, torsion, and malignancy. They can be derived from all three germ leaves and have different mesodermal and ectodermal tissue components such as hair, bone, and teeth. This study aimed to investigate the differences of mesodermal and ectodermal tissue components in mature cystic teratoma contents of the patients undergoing laparoscopic excision and to investigate the relationship between these tissue components and the tumor size. Patients who underwent laparoscopic mature cystic teratoma cyst excision in a university hospital in Bursa, Turkey between 01.01.2006 - 31.12.2018 were included in this retrospective study. Demographic characteristics of the patients, the diameter of the mature cystic teratoma cyst, bilaterality, lobulation, presence of hair, teeth, bone, cartilage tissue components in the tumor were evaluated. 236 women were included in the study. 222 patients underwent laparoscopic mature cystic teratoma cyst excision. 14 patients underwent other laparoscopic procedures, and mature cystic teratoma was found in the pathology specimen incidentally. Bilaterality rate was 15.2%. There were 58 mature cystic teratomas in 4-5 cm diameter, 78 in 5-6 diameter, 82 in 6-7 cm diameter and 54 mature cystic teratomas larger than 7 cm. As the diameter of the mature cystic teratoma increased, the presence of hair, teeth, or osseous tissue component or lobulation of the tumor increased significantly. In mature cystic teratomas larger than 7 cm, the possibility of including all three tissue components and lobulation reached the highest level of statistical significance. In conclusion, the size of the mature cystic teratoma and ectodermal tissue components of the tumor are proportional in laparoscopic mature cystic teratoma cyst excision procedures.

Keywords:

Mature cystic teratoma, Dermoid cyst, Ectodermal components,

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