Slučajni nalaz epitelnog tumora ovarijuma, odgovarajući pristup i očuvanje plodnosti
Sažetak
Uvod. Karcinom jajnika je peti vodeći uzrok smrti kod žena. Od ukupnog broja obolelih žena, 3–14% su mlađe od 40 godina i imaju želju za rađanjem. Studije su pokazale visoku stopu preživljavanja ukoliko se tumor dijagnostikuje i leči u ranom stadijumu, a petogodišnje preživljavanje iznosi 91,2%, pa se konzervativni način lečenja može smatrati validnom opcijom. Očuvanje fertiliteta je bezbedno za gradus 1 i 2 FIGO (International Federation of Gynecology and Obstetrics) stadijuma I epitelnih ovarijalnih karcinoma. Poštedna operacija podrazumeva salpingooforektomiju na strani tumora, multiple biopsije sumnjivih mesta, biopsije na slepo i infrakoličnu omentektomiju, kao i citološku analizu lavata. Prikaz bolesnika. Bolesnica stara 25 godina, G0, P0, javila se ginekologu zbog jakih bolova u maloj karlici. Ultrazvučnim pregledom dijagnostikovana je cistična hipoehogena promena na desnom jajniku promera 5 × 6 cm, suspektna na torziju zbog čega je bolesnica hitno operisana. Učinjena je desna cistektomija. Histopatološki nalaz operativno odstranjene ciste bio je: endometrijalni adenokarcinom ovarijuma, histološkog gradusa 2 (HG2) i nuklearnog gradusa 2 (NG2), bez limfovaskularne invazije i bez proboja kapsule, dostavljen u delovima. Kako urađenom operacijom nije utvrđen stepen rasprostranjenosti malignog tumora jajnika FIGO stadijum nije određen zbog čega je bilo neophodno uraditi reoperaciju u cilju određivanja stadijuma oboljenja prema FIGO protokolu za karcinom ovarijuma. Zaključak. Očuvanje fertiliteta kod pacijntkinja sa malignim tumorima jajnika predstavlja veliki izazov. Potrebno je zadovoljiti snažnu želju za ostvarivanjem materinstva, a da se ne smanji uspešnost u lečenju tog tipa oboljenja. Određivanje stadijuma raširenosti bolesti je od izuzetne važnosti za donošenje adekvatne odluke o načinu lečenja.
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