Objective: To examine cases of mature cystic teratoma (MCT) that were diagnosed and treated in our clinic regarding their association with fertility, and to detect the rate of malignant degeneration and the types of malignancies. Material and Methods: Patients who underwent surgery due to adnexal mass between April 2012 and August 2017 and were diagnosed as having MCT were retrospectively examined. The mean age of the 80 patients who met the inclusion criteria was 30.60±10.5 years. Nine had infertility according to hospital records. Sixty-seven percent of these (n=6) had accompanying endometriosis and MCT was bilateral in 55.5% (n=5). Malignant degeneration was present in 6.25% (n=5), all were monodermal tumors. Malignant degeneration was more common among patients with larger diameter adnexal masses (9.1±2.9 cm) and in those of postmenopausal age. Tumor markers were within the normal range for patients who developed malignancy. Malignant degeneration was not present among infertile patients with endometriosis. Results: Although MCTs do not seem to negatively affect the ovarian reserve, infertility is prominent in patients with concurrent endometriosis. During assessment, concurrent endometriosis should be considered. Imaging findings, large adnexal masses, and postmenopausal period are important for the assessment of MCT concerning malignant degeneration. It should not be overlooked because tumor markers may be normal. Conclusion: MCTs can be present concurrent with endometriomas. In such cases, infertility is more distinct. In MCT malignant degeneration, mass diameter, complex mass internal structure, and postmenopausal status are important factors.
MCTs can be present concurrent with endometriomas. In such cases the complaints of infertility are more distinct. In MCT malign degeneration, mass diameter, complex mass internal structure and postmenopausal status are important factors.
Breast cancer is a common malignancy among women. Due to the improvement of social awareness and advances in imaging technologies, significant achievements are obtained at its diagnosis and treatment each passing day. A 54-year-old, multiparous and postmenopausal woman, who presented with a palpable lymph node in the right supraclavicular region and a right adnexal mass but had no findings from the breast examination, is reported in this article. Following advanced assessment, metastatic carcinoma was identified in the lymph node biopsy and the adnexal mass. During the exploration for the primary origin, microinvasive breast cancer was diagnosed following mammographic imaging and an excisional biopsy from the right breast. Microinvasive breast cancer, which did present itself with clinical findings with metastases despite the lack of local findings, was discussed with the review of the literature.
A B S T R AC T Objective:Our aim in this study was to investigate the value of lower gastrointestinal system (GIS) endoscopy regarding the detection of colon invasion and its importance in recognizing primary and secondary ovarian cancers in cases clinically prediagnosed as advanced stage ovarian cancers. Materials and Methods:Records of patients, who were operated due to adnexal mass suspicious for malignancy at our clinic between September 2012 and May 2017, were examined. One hundred thirteen cases of advanced stage (Stage III -IV) malignant adnexal masses were detected. Results:Cases that underwent laparotomy because of a prediagnosis of malignant adnexal mass (mostly ovarian), and had stage III and IV disease, were compared regarding clinical characteristics and foreseeing bowel resection (51 patients had undergone lower GIS endoscopy, 62 had not). Six of the 51 patients, who underwent endoscopy, were diagnosed with colon involvement during endoscopy while 4 other patients were diagnosed intraoperatively. Among the 62 patients, without preoperative endoscopy, 10 patients underwent intraoperative bowel resection. The mean age of the patients with bowel resection was 57.35±13.53y; the mean age of the remaining patients was 55.8±12.54y. Rectosigmoid region was the most common area of resection (17/20). The positive predictive value of colonoscopy for predicting bowel resection was 100%, while the negative predictive value was 91%. Conclusion:Bowel resection is a pivotal component of the surgical approach to advanced stage malignant adnexal masses. The detection of tumor spread in lower GIS endoscopy is very important while planning the surgery, dealing with postoperative stoma problems and emotional issues and during the differential diagnosis of metastatic tumors.
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