Derin adenomyozis odaklarında endometrial karsinom tutulumu ve bu odaklara komşu minimal myoinvazyonun prognostik önemi

Amaç: Derin adenomyozis odaklarında, yüzey endometriumdan kaynaklanan endometrial karsinom tutulumu ve bu odaklara komşu minimal myoinvazyonun prognostik önemini araştırmak. Materyal ve Metod : Yukarıdaki tanıma, uyan, uluslararası jinekoloji ve obstetrik federasyonu (FIGO) grade I ve FIGO evre I olan altı adet endometrial karsinomlu olgu 7-27 (ortalama 17)' ay arasında değişen süreyle izlendi. Bulgular 7-27 ay arasında değişen süreyle izlem sonucunda, altı olgunun hiçbirinde nüks ya da ölüm saptanmadı. Sonuçlar. Olgu sayısının azlığı ve takip süresinin kısalığı nedeniyle istatiksel olarak desteklenmiş bir sonuca ulaşamamakla birlikte, bulgularımız; endometrial karsinom tarafından tutulmuş derin adenomyozis odaklan ve buna komşu minimal myoınvazyonun,derin gerçek myoinvazyon gibi davranmadığını düşündürmektedir. Henüz aydınlanmamış olan bu konuda geniş ve uzun takipli çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

Endometriyoz, Endometriyum neoplazmları, Genital neoplazmlar, dişi

Prognostik significance of deep adenomyotic foci involvement with minimal invasion of surrounding myometrium in endometrial carcinoma

Objective: To investigate prognostic significance ofdeep adenomyotic foci involvement with minimal invasion of surrounding myometrium in endometrial carcinoma Material and Method: Six cases of endometrial adenocarcinoma involving adenomyosis as defined above were followed-up between 7 and 27 months(mean 17 months). All cases were InternationalFederation of Gynecology and Obstetrics (FIGO) grade I and FIGO stage I. Resuts: After 7-27 months follow-up, ali cases were alive with no evidence of recurrent disease. Conlusion: Because of the small number of cases in this study and the short duration of follow up, we couldn't get any statistical support. Eventhough, deep adenomyotic foci involvement with minimal invasion of surrounding myometrium in endometrial carcinoma don't seem to behave like ordinary myoinvasion at same level. it is necessary further investigations with large number of cases and long follow-up periods on this subject which has not been completely enlightened yet.

Keywords:

Endometriosis, Endometrial Neoplasms, Genital Neoplasms, Female,

___

1. Nasçimento AF, Hirsch MS, CvikoA, Quade BJ, Nucci MR. The role of CD 10 staining in distinguishing invasive endometrial adenocarcinoma from adenocarcinoma involving adenomyosis. Mod Pathol2003; 16: 22-7
2. HallBJ, Young RH, Nelson JH. The prognostic significance of adenomyosis in endometrial carcinoma.- Gynecol Oncol 1984; 17: 32-40
3. S as ahT, Sugiyama T, Nanjo Hetal. Endometrioid adenocarcinoma arising from adenomyosis: report and immunohistochemical analysis of an unusual case. PatholInt 2001; 51: 308-13
4. TakaiN, Akizuki S, Nasu K, Etoh Y, Miyakawal. Endo-metrioid adenocarcinoma arising from adenomyosis. Gynecol Obstet Invest 1999; 48: 141-4
5. Ichikawa Y, Takano K, Tanabe M. et al. Endometrial carcinoma coexisting with pregnancy, presumed to derive from adenomyosis:a case report. Int J Gynecol Cnacer 2001: 11; 488-90
6. Hernandez E, Woodruff JD. Endometrial adenocarcinoma arising in adenomyosis. Am J obstet Gynecol 1980; 138: 827-32
7. facques SM, Lawrence WD. Endometrial adenocarcinoma with variable-level myometrial involvement limited to adenomyosis: a clinicopathologic study of 23 cases. Gynecol Oncol 1990; 37: 401-7
8. Mittal KR, Berwick KW. Endometrial adenocarcinoma involving adenomyosis without true myometrial invasion is characterized by frequent piece ding estrogen therapy low histologic grades and excellent prognosis. Gynecol Oncol 1993; 19: 197-201
9. Longacre TA, Hendrickson MR. Diffusely infiltrative endometrial adenocarcinoma, an adenoma malignum pattern of myoinvasion. Am J Surg Pathol 1999; 23; 69-78
10. Srodon M, Klein WM, Kurman RJ. CD 10 immunostaining does not distinguish endometrial carcinoma invading myometrium from carcinoma involving myometrium from carcinoma involving adenomyosis. Am J Surg Pathol2003; 27: 786-9
11. DiSaia, Creasman, Textbook of Gynecologic Oncology, 2002, pg 157