Ateş KARATEKE, Mehmet GÜZELGÜL, SELÇUK AYAS, Çetin ÇAM, Mehmet REŞİT ASOĞLU

Overin Granüloza Hücreli Tümörlerinde Klinik Deneyimlerimiz

Amaç: Seks-kord stromal tümörler tüm over malignitelerinin yaklaşık olarak %5-8' ini oluştururlar ve bunlar içinde en sık görüleni granüloza hücreli tümörlerdir. Bu çalışmada; kliniğimizde granüloza hücreli tümör tanısı almış olgulardaki deneyimlerimiz incelenmiştir.Gereç ve yöntemler: Bu çalışmaya, hastanemiz jinekolojik onkoloji kliniğinde 2005-2009 yılları arasında opere edilen granüloza hücreli over tümörü olan 18 olgu dahil edildi. Bu olgular; tanı anındaki yaş, fertilite arzusu, tanıdaki semptomlar, endometrium durumu, parite, tümör evresi, tümör grade, tümör çapı, cerrahi tedavi şekli, adjuvan tedavi uygulanıp uygulanmadığı, sağ kalım, rekürrens ve ölüm açısından değerlendirildi.Bulgular: Olguların tanı anındaki ortalama yaşı 49 ± 15.4 yıl olarak hesaplandı. Tanı anındaki en sık semptomlar anormal uterin kanama (%72) ve abdominopelvik ağrı (%67) idi. Preoperatif değerlendirilmede 2 endometrial hiperplazi ve 1 endometrium kanseri tespit edilmişti. Olguların ortalama takip süresi 4.3 ± 1.4 yıl olarak hesaplandı. Olguların 13' ü (%72.2) evre I, 2' si (%11.1) evre II, 3' ü (%16.7) evre III olarak bulundu. Postoperatif adjuvan tedavi olguların 11' ine (%61) verilmişti. Takip süresinde %11 oranında nüks izlendi. Sonuçlar: Overin granüloza hücreli tümörleri nadir görülmektedir ve ilk tanıdan yıllar sonra bile nüks etme eğilimindedirler. Bu tümörlerin tedavisi cerrahidir ve fertilitesini devam ettirmek isteyen olgularda fertilite koruyucu cerrahi yapmak mümkündür. Bizim granüloza hücreli tümörlerle ilgili deneyimlerimiz literatür ile uyumludur. Ancak; bu konuda randomize çalışmaların azlığı nedeniyle konunun tüm yönleri net olarak ortaya konulamamıştır. Bu konuyla ilgili prospektif randomize çalışmalara ihtiyaç vardır

Our Clinical Experience in Granulosa Cell Tumors of the Ovary

Objective: Sex-cord-stromal tumors (SCSTs) represent approximately 5-8% of all ovarian malignancies. Granulosa cell tumors are the most common malignant tumors in the group of SCSTs. In this trial, we present our experiences in patients with granulosa cell tumor.Material and methods: 18 patients with granulosa cell tumor operated in our hospital between 2005 – 2009 are included and evaluated for age, wish for the preservation of fertility, symptoms, condition of endometrium, parity, stage of tumor, tumor grade, diameter of the tumor, type of surgical treatment, use of adjuvant treatment, survival, recurrence and mortality’.Results: Average age of the patients are 49 ± 15.4 . The most common symptoms were abnormal uterine bleeding (72%) and pelvic pain (67%) on admission. On preoperative evaluation, 2 endometrial hyperplasia and 1 endometrium cancer were diagnosed. The average follow-up time was 4.3 ± 1.4 years, 13 (72.2%), 2 (11.1%) and 3 (16.7%) of the patients presented with stage 1, 2 and 3, respectively. Postoperative adjuvant therapy was given to 11 of the patients (61%).Recurrence rate was 11% along follow up time. Conclusion: Granulosa cell tumors are rare tumors and may recurrence later. Surgery represents the most important therapeutic arm. Conservative surgery, preserving the possibility of a future pregnancy can be performed. Our experiences are coherent with literature. However, there is a lack of number of randomized clinical trials, and prospective randomized controlled trials are needed

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