[PP-066]
Nadir Bir Mesane Tümörü: Dermoid Kist
Abdullah Gul1, Ahmet Sahan1, Canan Firat2, Yiloren Tanidir32TC SB SBÜ Van Eğitim Ve Araştırma Hastanesi, Patoloji Departmanı, Van
3Marmara Üniversitesi, Üroloji Ana Bilim Dalı, İstanbul
GİRİŞ: Dermoid kistler gelişimsel iyi huylu anomalilerdir ve en az iki germ yaprağı içerirler. Dermoid kistin genellikle primordial germ hücre orijinli olduğu bilinir; fakat diğer orta hat ve paraxial organlarda da saptandığı nadir vakalar vardır. Çoğunlukla overlerde yerleşen dermoid kistler, nadiren mesane gibi diğer organlarda da saptanabilirler.
METOD: Primer mesane dermiod kistli 47 yaşında bayan hasta sunmaktayız. Makroskopik hematüri şikayetiyle polikliniğimize başvuran hastaya yapılan üriner ultrasonda mesane lümenine protrüze 1x1 cm kitle saptandı. Hastaya yapılan sistoskopide, mesane posteriorunda divertikül içinde 1x1cm solid karakterde kitle tespit edildi. Mesanenin diğer tarafları tamamen doğaldı.
SONUÇ: Mesanedeki kitleye complete en-bloc rezeksiyon yapıldı. Mikroskopik değerlendirmede, katmanlı yassı epitelden oluşan birden fazla cilt dokusu saptanırken, üretelyal epitel görülmedi. Saç folikülleri ve yağ bezleri gibi deri ekleri gözlemlendi (Fig. 1A-B). Ayrıca, epidermal (infundibular) kiste benzeyen bir kist saptandı(Fig. 1C-D). Histopatolojik tanı dermoid kist olarak yorumlandı.
Çıkarım: Dermoid kistler mesanede nadiren görülür. Literatür tarandığında, 9’u İngilizce olarak yazılmış olan toplamda sadece 11 adet mesane dermoid kist vakası bulunmuştur. Mesane dermoid kisti, alışılmadık ve nadir bir mesane mesane tümörü olarak akılda tutulmalı ve hastalara bunun iyi huylu olduğu ve takibe gerek olmadığı anlatılmalıdır.
An Unusual Bladder Mass: Dermoid Cyst
Abdullah Gul1, Ahmet Sahan1, Canan Firat2, Yiloren Tanidir32Department of Pathology, University of Ministry of Health, Van Training & Research Hospital, Van, Turkey
3Marmara University, School of Medicine, Department of Urology, Istanbul, Turkey
BACKGROUND: Dermoid cysts are developmental benign anomalies and comprise at least two germ layer tissue. Dermoid cyst is usually known to be of premordial germ cell origin; however, there are some rare cases in which it has been noticed in other midline and paraaxial organs. Although they generally settle in ovaries, they might be found in other tissues. They are very rare in bladder.
METHODS: We presented here a 47 year-old female with primary urinary bladder dermoid cyst. She had macroscopic hematuria. The urinary ultrasound revealed an 1x1 cm solid mass within the lumen of the urinary bladder. At cystoscopy, a single protruted 1x1 cm solid mass from a small diverticule was located at the posterior wall of the bladder. The rest of the bladder mucosa was normal.
RESULTS: Complete transuretheral en-bloc resection was performed to the mass. Microscopic examination revealed multiple skin tissues lined by stratified squamous epithelium. Urothelial epithelium was not seen. Skin appendages, such as hair follicles and sebaceous glands, were observed in sections(Fig. 1A-B). Also a cyst which resembles an epidermal (infundibular) cyst, was determined(Fig. 1C-D). The histopathological diagnosis was dermoid cyst.
CONCLUSION: Dermoid cysts are rarely seen in the urinary bladder. In the literature research with bladder dermoid cyst, we could only find 11 cases reported and cited in which only 9 of them were written in English. Bladder dermoid cyst should be reminded as an unusual bladder mass and the patients can be reassured that it is benign and there is no need for further following up.
Mikroskopik Görüntüler
Microscopic Images
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(A) Photomicrograph demonstrates stratified squamous epithelium and pilosebaceous units (H&E, Original magnification x40). (B) High-power view of the hair follicle (right top) and sebaceous glands (bottom) (H&E, Original magnification x200).(C) Image of epidermal (infundibular) cyst whose lumen is keratin-filled (H&E, Original magnification x40). (D) On the left side, lamellated keratin can be seen, on the right side flattened squamous epithelium is distinguished (H&E, Original magnification x100).
(A) Photomicrograph demonstrates stratified squamous epithelium and pilosebaceous units (H&E, Original magnification x40). (B) High-power view of the hair follicle (right top) and sebaceous glands (bottom) (H&E, Original magnification x200).(C) Image of epidermal (infundibular) cyst whose lumen is keratin-filled (H&E, Original magnification x40). (D) On the left side, lamellated keratin can be seen, on the right side flattened squamous epithelium is distinguished (H&E, Original magnification x100).