Tam Metin PDF (3983 KB) - Marmara Medical Journal

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Marmara Medical Journal 2006;19(2);73-76 Osman Kurukahvecioğlu, et al. Laparoscopıc approach for epiphrenic esophageal diverticula 3. Schultz SC, Byrne DM, De Cunzo P, Byrne WB. Carcinoma arising within epiphrenic diverticula. A report of two cases and review of the literature. J Cardiovasc Surg 1996; 37: 649-651. 4. Rosati R, Fumagalli U, Bona S, Bonavina L, Peracchia A. Diverticulectomy, myotomy and fundoplication through a laparoscopy: A new option to treat epiphrenic esophageal diverticula? Ann Surg 1998; 227: 174-178. 5. Evander A, Little AG, Ferguson MK, Skinner DB. Diverticula of the mid and lower esophagus: Pathogenesis and surgical management. World J Surg 1986; 10: 820-828. 6. Fernando HC, Luketich JD, Samphire J, et al. Minimally invasive operation for esophageal diverticula. Ann Thorac Surg. 2005; 80: 2076- 2080. 7. Streitz JM, Glick ME, Ellis H. Selective use of myotomy for treatment of epiphrenic diverticula: Manometric and clinical analysis. Arch Surg 1992; 127: 585-588. 8. Gockel I, Eckardt VF, Junginger T. Epiphrenic diverticulum: Possible causes and surgical therapy. Chirurg 2005; 76: 777-782. 9. Abe T, Tangoku A, Oka M. Esophageal diverticula. Nippon Geka Gakkai Zasshi. 2003; 104: 601-605. 76
CASE REPORTS NEONATAL MIXED SEX-CORD STROMAL TUMOR OF THE TESTIS: A CASE REPORT Asıf Yıldırım 1 , Erem Başok 1 , Adnan Başaran 1 , Ebru Zemheri 2 , Reşit Tokuç 1 1 SB İstanbul Göztepe Eğitim ve Araştırma Hastanesi, Üroloji, İstanbul, Türkiye 2 SB İstanbul Göztepe Eğitim ve Araştırma Hastanesi, Patoloji, İstanbul, Türkiye ABSTRACT Sex cord-stromal tumors of the testis are rare. We report a mixed type sex-cord stromal tumor in neonate. According to published reports, sex-cord stromal testis tumors exhibit benign behavior in prepubertal patients. However, undifferentiated stromal tumor with a large number of mitotic figures may exhibit metastatic behavior. Keywords: testis, sex cord-stromal tumor, neonate NEONATAL TESTİS MİKST SEKS-KORD STROMAL TÜMÖR: OLGU SUNUMU ÖZET Testisin seks-kord stromal tümörü nadir olarak görülmektedir. Bu yazıda, neonatal testisin mikst tipte sekskord stromal tümör olgusu sunuldu. Literatüre bakıldığında, prepübertal dönemde testisin seks-kord stromal tümörleri benign seyir göstermektedir. Buna karşın, çok sayıda mitotik aktivite ile diferansiye-olmayan stromal tümör malign davranış gösterebilir. Anahtar Kelimeler: testis, seks kord-stromal tümör, neonatal INTRODUCTION Testis tumors in the neonate are extremely rare and with the exception of the previous reports of the Tumor Registry data, few cases have been documented in the literature. 1 Sex-cord stromal testis tumors represent only 5% of all testicular neoplasms, and include Leydig cell, Sertoli cell, juvenile granulosa cell, thecal cell tumors, mixed cell types and undifferentiated tumors. 2 We report a case of neonatal mixed sex-cord stromal tumor and discuss its diagnosis and treatment. To our knowledge no such cases have been reported in the literature. CASE PRESENTATION An otherwise healthy full-term male infant was referred for a markedly enlarged and firm right testis. On physical examination both testes were descended, and the right testis was enlarged and non-tender (Figure 1). Color Doppler ultrasound showed a solid cystic mass with microcalcification, which had entirely replaced the normal testicular parenchyma (Figure 2). Serum AFP was 13.927 ng/ml (normal range 0.6- 16.387). Inguinal exploration and right radical orchiectomy were performed. The gross appearance was primarily of tan-yellow nodular lesions containing multiple thin-walled cysts with hemorrhagic fluid (Figure 3). Pathological examination revealed small nests, narrow cords and thick trabeculae, tubular structure enveloped by fine connective tissue and a mixed sex-cord stromal (sertoli cell and juvenile granulosa cell) tumor that had completely replaced the testis. (Figure 4). Immunohistochemical study of the tumor showed a strong positivity for vimentin, inhibin-alfa and a negative staining for alphafetoprotein (AFP), Carcinoembryogenic antigen (CEA), placental-like alkaline phosphatase (PLAP), cytokeratin, epithelial membrane antigen (EMA) and desmin (Figure 5). The patient did well postoperatively and at 16 months follow-up AFP was normal. İletişim Bilgileri: Asıf Yıldırım e-mail: asifkad@superonline.com SB İstanbul Göztepe Eğitim ve Araştırma Hastanesi, Üroloji, İstanbul, Türkiye 77 Marmara Medical Journal 2006;19(2);77-79
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