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  • Küçük Resim
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    Comparison of clinical indications and postoperative histopathological diagnoses of hysterectomy specimens with benign preliminary diagnoses
    (2019) Bozdag, Zehra; Dizibuyuk, Omer Faruk; Bayramoglu Tepe, Neslihan
    Aim: Hysterectomy specimens constitute a large section of routine pathology practice as hysterectomy operations widely performed all over the world to manage benign gynecological disorders by the gynecologists. In this study, we aimed to evaluate hysterectomy specimens obtained due to benign preliminary diagnoses by comparing them with regard to clinical indications and postoperative histopathological diagnoses. Material and Methods: Nine hundred and forty-seven cases who underwent hysterectomy at Gaziantep University Medical Faculty Hospital between January 2012 and December 2016 were retrospectively re-evaluated with regard to clinical indications and postoperative histopathologic diagnoses. Results: Leiomyoma was the most common hysterectomy indication and accounted for 34.1% (n:323). Other indications in descending order of prevalence were as follows; abnormal uterine bleeding (n:290, 30.6%), endometrial hyperplasia (n:113, 11.9%), uterine prolapse (n:107, 11.3%), adenomyosis (n:75, 7.9%) and abnormal placentation (n:39, 4.1%). According to the final histopathological results of the hysterectomy specimens, leiomyomas (n:325, 34.3%) were the most common postoperative diagnosis followed by adenomyosis (n:150, 15.8%) and endometrial hyperplasia (n:113, 11.9%). Abnormal placentation was found in 39 cases (4.1%). Squamous intraepithelial lesions of the uterine cervix were found in 39 cases (4.1%), endometrial adenocarcinomas in 10 cases (0.9%), smooth muscle tumor with uncertain malignant potential, leiomyosarcoma and granulosa cell tumor in one patient each (0.09%). We found more than one pathology in 280 cases. The most common pathology was leiomyomas coexisting with adenomyosis (n:170, 17.9%), while others included leiomyoma coexisting with endometrial polyp (n:56, 5.9%), and leiomyoma coexisting with endometrial polyp and adenomyosis (n:54, 5.7%). Conclusion: Incidental detection of conditions such as cervical squamous intraepithelial lesions and endometrial adenocarcinomas in hysterectomy materials obtained for benign preliminary diagnoses support the importance of cervical screening test and endometrial sampling as routine processes in preoperative surgical examinations. This also stresses the importance of macroscopic examination and increased sampling in suspicious cases for pathologists
  • Küçük Resim
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    Gastrointestinal system-derived secondary gynecologic tumors: 10 years experience at a single center
    (2019) Bayramoglu Tepe, Neslihan; Bozdag, Zehra; Balat, Ozcan
    Aim: To perform a retrospective review of gynecologic malignancies originating from gastrointestinal system (GİS).Material and Methods: The study included 35 patients who underwent surgery at Gaziantep University, Faculty of Medicine, Department of Gynecology and Obstetrics from January 2007 to December 2017 and were diagnosed with secondary gynecological malignancies originating from GİS. The patients’ age, primary tumor, metastatic tumor localization and size were recorded. The malignancies were classified based on origin, as those arising from the colon, appendix, pancreas, stomach, peritoneum, and those of an unknown origin. Results: The mean age of the patients was 50.8 years (min: 24, max: 98) and the mean tumor diameter was 9.8 cm (min: 2 cm, max: 23 cm). Malignancies originating from the colon were most common secondary gynecologic malignancies. The primary tumor was localized at the colon in 21 patients (60%), stomach in eight (22.8%), and in the pancreas in one patient, appendix in one patient, peritoneum in one patient (2.8%). The origin of the primary tumor could not be determined in three patients (8.5%). Of the malignancies originating from the colon (n=21), 16 (76.1%) metastasized to the ovaries, four (19%) to the vagina, one (4.7%) to the cervix, while all tumors originating from the stomach, peritoneum, pancreas, appendix and those derived from the GIS without specific origin metastasized to the ovaries. Of the ovarian metastases, 26 (86.6%) were bilateral while four (13.3%) were unilateral. Conclusion: Female genital system is among the substantial targets of metastasis of GIS-derived tumors. Metastatic tumors have a more aggressive behavior. Metastatic tumors must be distinguished from primary tumors as treatment modalities differ in these tumors. A multidisciplinary approach should be employed in the diagnosis, management and follow-up of cases, and the genital system should be screened carefully during both preoperative assessment and postoperative follow-up in patients with primary GIS malignancies.Keywords: Metastatic Tumor; Gynecologic Tumor; Gastrointestinal System.