Ilk basvuruda primer odagi bilinmeyen metastatik karaciger tümörlü 43 olgunun irdelenmesi
Analysis of 43 cases with liver metastases and the primary focus unknown on the first admittance
- Ana Sayfa
- Sayılar
- Ilk basvuruda primer odagi bilinmeyen metastatik karaciger tümörlü 43 olgunun irdelenmesi...
Özet
Giris ve amaç: Primeri bilinmeyen metastatik karaciger tümörlü hastalari n prognozu kötü seyretmekle birlikte, nöroendokrin tümörler gibi bazi tümör metastazlarinda göreceli olarak daha iyi prognoz beklenir. Bu durumdan dolayi bu hastalarda, tümörün histopatolojik özelligi tedavi ve takipte önem kazanmaktadir. Bu çalismanin amaci metastatik karaciger tümörlü olgularimizin histopatolojik ve sitolojik olarak retrospektif degerlendirilmesidir. Gereç ve yöntem: Gastroenteroloji Kliniginde Ocak 2000-Mayis 2003 tarihleri arasinda yatan ve biyopsi yapilarak metastatik karaciger tümörü tanisi alan 43 olgunun dosyalari retrospektif olarak degerlendirilmistir. Primer karaciger tümörleri, kolanjiyoselüler karsinom ve lenfoma tanisi alan olgular ile kayitlari yetersiz olan olgular çali smadan dislanmislardir. Olgular yas, cinsiyet, histopatolojik ve sitolojik tanilari ve eger saptanmissa primer odaklari açisindan degerlendirilmistir. Bulgular: 23’ü erkek, 20’si kadin olan 43 olgunun ortalama yasi 59 (19-88) dur. Metastatik tümörlerin histopatolojik degerlendirilmesinde; 26’sinda (%60) adenokarsinom, 8’inde (%18) nöroendokrin tümör, 4’ünde (%9) anaplastik karsinom ve 5’inde diger tümör metastazi saptanmi stir. 37 (%86) olgunun sitolojik incelemesi malign, 5’inin (%11) benign ve 1 (%3) olgunun da kuskulu olarak rapor edilmistir. Sitolojik incelemenin duyarliligi %86 bulunmustur. 17’sinde (%40) primer odak bulunmus, 26 (%60) olgu primeri bilinmeyen metastatik karaciger tümörü tanisi almistir. Sonuç: Metastatik karaciger tümörü ile basvuran nöroendokrin tümör sikligimiz ve primeri saptanan hasta sikligimiz literatürde belirtilenden daha yüksektir. Metastatik karaciger tümörlü olgularda biyopsi yapilmalidir.
Abstract
Background/aim: Although patients with liver metastases and unknown primary focus have poor prognosis, some have a relatively good prognosis, such as cases of liver metastases of neuroendocrine tumors. Thus, the histopathological property of these metastatic tumors is valuable in treatment and follow-up of these patients. The aim of this study was to evaluate the histopathological and cytological properties of our patients with liver metastases retrospectively. Materials and methods: The medical reports of 43 patients who were hospitalized at the Gastroenterology Department between January 2000-May 2003 and diagnosed to have biopsy- proven liver metastases were reviewed retrospectively. Patients who were diagnosed to have primary hepatic tumor, cholangiocarcinoma, or lymphoma and those with insufficient medical records were excluded. Age, sex, histopathological and cytological diagnoses and, if found, primary focus of malignancy of the patients were evaluated. Results: The mean age of the 43 patients (23 males, 20 females) was 59 years (range: 19-88). Histopathological spectrum included adenocarcinoma in 26, neuroendocrine tumor in 8, anaplastic carcinoma in 4, and other in 5. Malignant cytology in 37 (86%), benign cytology in 5 (11%) and suspected cytology in 1 (3%) were reported. Sensitivity of the cytology was found to be 86%. Primary focus of malignancy was found in 17 (40%) patients and 26 (60%) patients were diagnosed to have a malignancy of unknown primary focus with liver metastases. Conclusion: Both the percentage of neuroendocrine tumors presenting with liver metastases and the percentage of patients whose primary focus of malignancy unknown were found to be higher than the percentage reported in literature. We suggest that liver biopsy should be performed in metastatic liver tumors.
