Sažetak
Uvod. Ekstrapulmonalni sitnoćelijski karcinom je retka, prognostički loša kategorija tumora. Primarno, može da se lokalizuje u skoro svim organima, pa i u jajniku, gde zbog svojih kliničkih specifičnosti, često predstavlja pravi dijagnostički i terapijski izazov. Sitnoćelijski karcinom jajnika (small cell ovarian carcinoma – SCOC) biološki je vrlo agresivan maligni tumor nepoznate histogeneze. U radu je prikazana bolesnica u post-menopauzi sa sitnoćelijskim karcinomom jajnika i hiperkalcemijom, agresivnog toka i fatalnog ishoda, u International Federation of Gynecology and Obstetrics – FIGO Ia stadijumu. Prikaz bolesnika. Žena stara 60 godina, javila se zbog tegoba u donjem abdomenu praćenih bolom jakog intenziteta. Ultrazvučnim pregledom i kompjuterizovanom tomografijom abdomena ustanovljeno je prisustvo velike adneksalne mase cističnog izgleda sa najvećim promerom od 13 cm, sa urednom strukturom drugih ginekoloških organa i bez prisustva metastatskih depozita. Svi rezultati laboratorijske analize bili su u granicama normalnih vrednosti izuzev povišenih nivoa kalcijuma u serumu. Izvršena je eksplorativna laparotomija sa kompletnom histerektomijom, bileteralnom salpingooforektomijom, disekcijom limfnih čvorova i omentektomijom. Na osnovu patohistološke analize operatvnog materijala postavljena je dijagnoza SCOC stadijuma Ia. U postoperativnom periodu nije bilo komplikacija i bolesnica je otpuštena deset dana posle operacije u dobrom stanju i normalizovanom kalcemijom. Lečenje je nastavljeno istovremenom radio- i hemioterapijom. Međutim, bez obzira na preduzete mere lečenja, bolest je progradirala i bolesnica je umrla zbog diseminovane metastatske bolesti 26 meseci posle postavljanja dijagnoze. Zaključak. Sitnoćelijski karcinom lokalizovan u jajniku najčešće je kategorija tumora sa lošom prognozom u zavisnosti od faze bolesti.
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Reference
van der Heijden HF, Heijdra YF. Extrapulmonary small cell car-cinoma. South Med J 2005; 98(3): 345−9.
Woopen H, Sehouli J, Pietzner K, Darb-Esfahani S, Braicu EI, Foto-poulou C. Clinical experience of young patients with small cell ovarian carcinoma of the hypercalcemic type (OSCCHT). Eur J Obstet Gynecol Reprod Biol 2012; 165(2): 313−7.
Haider K, Shahid RK, Finch D, Sami A, Ahmad I, Yadav S, et al. Extrapulmonary small cell cancer: a Canadian province's expe-rience. Cancer 2006; 107(9): 2262−9.
Cannon PM, Smart CR, Wilson ML, Edwards CB. Hypercalcemia with ovarian granulosa cell carcinoma. Rocky Mt Med J 1975; 72(2): 72−4.
Dickersin GR, Kline IW, Scully RE. Small cell carcinoma of the ovary with hypercalcemia: a report of eleven cases. Cancer 1982; 49(1): 188−97.
Tavassoli FA, Devilee P. Worald Health Organization Classifica-tion of Tumors. Pathology and Genetics of Tumors of the Breast and Female Genital Organs. Lyon: IARC Press; 2003.
Young RH, Oliva E, Scully RE. Small cell carcinoma of the ovary, hypercalcemic type. A clinicopathological analysis of 150 cases. Am J Surg Pathol 1994; 18(11): 1102−16.
Harrison ML, Hoskins P, du Bois A, Quinn M, Rustin GJ, Leder-mann JA, et al. Small cell of the ovary, hypercalcemic type -- analysis of combined experience and recommendation for management. A GCIG study. Gynecol Oncol 2006; 100(2): 233−8.
Kopp LM, Desoky S, Pugh J, Herzog CE. Small cell carcinoma of the ovary of the hypercalcemic type presenting in a 5-year-old girl. J Pediatr Hematol Oncol 2013; 35(5): e217−8.
Pautier P, Ribrag V, Duvillard P, Rey A, Elghissassi I, Sillet-Bach I, et al. Results of a prospective dose-intensive regimen in 27 pa-tients with small cell carcinoma of the ovary of the hypercal-cemic type. Ann Oncol 2007; 18(12): 1985−9.
Hamilton S, Beattie GJ, Williams AR. Small cell carcinoma of the ovary: a case report of 3 cases and review of the literature. J Obstet Gynaecol 2004; 24(2): 169−72.
Kim JH, Lee SH, Park J, Kim HY, Lee SI, Nam EM, et al. Extra-pulmonary small-cell carcinoma: a single-institution experience. Jpn J Clin Oncol 2004; 34(5): 250−4.
Kim K, Lee H, Chun S, Shin S, Kim M, Lee K, et al. Clinical over-view of extrapulmonary small cell carcinoma. J Korean Med Sci 2006; 21(5): 833−7.
Estel R, Hackethal A, Kalder M, Münstedt K. Small cell carcinoma of the ovary of the hypercalcaemic type: an analysis of clinical and prognostic aspects of a rare disease on the basis of cases published in the literature. Arch Gynecol Obstet 2011; 284(5): 1277−82.
Martinez-Borges AR, Petty JK, Hurt G, Stribling JT, Press JZ, Castel-lino SM. Familial small cell carcinoma of the ovary. Pediatr Blood Cancer 2009; 53(7): 1334−6.
Dickersin GR. The role of electron microscopy in gynecological pathology. Int J Gynecol Pathol 2000; 19(1): 56−66.
Walt H, Hornung R, Fink D, Dobler-Girdziunaite D, Stallmach T, Spycher MA, et al. Hypercalcemic-type of small cell carcinoma of the ovary: characterization of a new tumor line. Anticancer Res 2001; 21(5): 3253−9.
McCluggage GW. Ovarian neoplasms composed of small round cells: a review. Adv Anat Pathol 2004; 11(6): 288−96.
McCluggage WG, Oliva E, Connolly LE, McBride HA, Young RH. An immunohistochemical analysis of ovarian small cell carci-noma of hypercalcemic type. Int J Gynecol Pathol 2004; 23(4): 330−6.
Dabbs D. Diagnostic immunohistochemistry. 3rd ed. Philadel-phia: Saunders & Elsevier; 2010.
Chen L, Dinh TA, Haque A. Small cell carcinoma of the ovary with hypercalcemia and ectopic parathyroid hormone produc-tion. Arch Pathol Lab Med 2005; 129(4): 531−3.
Matoso A, Singh K, Jacob R, Greaves WO, Tavares R, Noble L, et al. Comparison of thyroid transcription factor-1 expression by 2 monoclonal antibodies in pulmonary and nonpulmonary pri-mary tumors. Appl Immunohistochem Mol Morphol 2010; 18(2): 142−9.