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Hipofiz Makroadenomu Olan 25 Hastanın Retrospektif Olarak Değerlendirilmesi

Retrospective Analyses of 25 Patients with Pituitary Macroadenomas

Journal Name:

  • İnönü Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 2004

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Aim: The aim of this study is to retrospectively evaluate the 25 patients (15 female, 10 male, mean age 43.24 ± 15.44 years) with pituitary macroadenomas; 12 clinically non-functioning tumors (CNFTs), 6 prolactinomas, 5 acromegalies, and 2 craniopharingiomas attempted to our Neurosurgery and Endocrinology Clinics. Methods: The patients were evaluated demographically and endocrinologically with the nature of the tumor and operation modalities. Results: Male dominancy was defined in CNFTs (58.3%), but in acromegalies (80%), and prolactinomas (66.6%) most of the patients were female. Both of the craniopharingiomas were women as well. Headache was the predominant (52%) complaint for all the cases, visual disturbances (36%) and hypogonadal symptoms (16%) were the others. Hypogonadotropic hypogonadism and hypopituitarism were the most frequent endocrinologic abnormalities at admission. Eighteen of the patients were operated. In 10 (40%) of them transsphenoidal surgery, and in 8 (32%) transcranial surgery was performed. The recurrence rate was 22.2%. Hypopituitarism was increased up to 50% (n=9) from 28%, and sustained diabetes insipidus from 4% to 27.8% (n=5) postoperatively. Conclusion: Despite new treatment modalities in functioning adenomas promise expectations, pituitary macroadenomas seem to sustain as a dilemma especially for the endocrinologic dysfunctions in regards of tumor mass effect or operation sequels.
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Abstract (Original Language): 
Amaç: Bu çalışmanın amacı, 2000-2004 yılları arasında Nöroşirurji ve Endokrinoloji Kliniklerimizde tedavi edilen hipofizer makroadenomlu 25 hastanın (15 kadın, 10 erkek, yaş ortalaması 43.24 ± 15.44 yıl) retrospektif olarak incelenmesidir. Yöntem: Hastalar demografik ve endokrinolojik bulgulara, tümörün çapı, yayılımı ve operasyon şekline göre değerle ndirilmi ştir. Bulgular: Olguların 12'si klinik olarak non-fonksiyone adenom (CNFT), 6'sı prolaktinoma, 5'i akromegali ve 2'si kranyofarinjiomadır. CNFT'lü vakalarda erkekler (%58.3), akromegali (%80) ve prolaktinomalarda (%66.6) ise kadınlar çoğunluktaydı. Kranyofarinjiomalı iki olgu da kadındı. Baş ağrısı (%52) görme bozuklukları (%36) and hipogonadal semptomlar (%16) başvuru anında belirtilen en sık şikayetlerdi. Hipogonadotropik hipogonadizm ve hipopitüitarizm tedavi öncesi tespit edilen en sık endokrinolojik bozukluklardı. Hastaların 18'i tümör özelliğine göre transsfenoidal (n = 10, %40) yada transkranyal yoldan (n=8, %32) opere edildi. Nüks oranı %22.2 bulundu. Operasyonlardan sonra hipopitüitarizmin %28'den %50'ye (n=9), ve kalıcı diabetes insipidusun %4'ten %27.8'e (n = 5) yükseldiği görülürken, vizyon bozukluklarının % 48'den %20'ye, oftalmopleji oranının ise %20'den %4'e düştüğü görüldü. Sonuç: Her ne kadar hipofiz adenomlarında yeni tedavi yaklaşımları umut vaat ediyorsa da, makroadenomlar gerek kitle etkileri gerekse operasyona bağlı nedenlerle endokrinolojik ve cerrahi açıdan hala ciddi bir sorun olarak görünmektedir.
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  • Turkish

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