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SÜRRENAL İNSİDENTALOMALARININ DEĞERLENDİRİLMESİ

Journal Name:

  • İstanbul Tıp Fakültesi Dergisi

Publication Year:

  • 2000

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
An evaluation of adrenal incidentalomas. The inereasing use of US, MRI, and CT scan in the dİagnosis of abdominal diseases has itnproved the deteetion of adrenal asymptomatic masses (incidentalomas). The natura! course of adrenal incidentalomas and the risk of sucn lesions to-ward honnonal hipersecretion or malignaney are stili under evaluation. Of 22 consecutive pa-tients with adrenal incidentaloma invesligated at our depaılmcnt in the last 5yr, 12 underwent surgery. The remaining patients wcrc enroiled in an endocrinologİcai follow~up between 3 months-5yr after diagnosis. Among these incidentalomas, 2 cases with silent Cushing syndro-me (%16.6), 3 cases with silent pheochromocytoma (%25), and 17 cases wİth non-funetioning adrenalomas (%55.4) were diagnosed by biochemical tests. Nonc of the patients vvho were fol-lowcd up developed malignaney: Only oııe showcd mass enlai'gement during follow-up. Histo-logical examinations of 12 operated incidentalomas inchıded 3 bening pheochromocytomas, 2 Cushing syndromc (adenoma and bilateral maero-nodular IıypcrpIasİa), one leiomyomatosis, 4 adrenocortical adenomas, one cysle. Thİs study provides a clear demonstration of the current opinion that some patients with İnci-dentaily discovered adrenal adenomas may be exposed to a silent hiperfunetion, since the biochemical abnormalitics do not become clinically manifesl, at least in the short term. İn these cases, early diagnosis will enhance pıevention and treatment.
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Abstract (Original Language): 
Batıniçi hastalıkların teşhisinde yaygın bir şekilde kullanılmaya başlanan ultrasonogıafi, mag-netik resonans görüntüleme ve bilgisayarlı tomografi yöntemleri asemptomatik sürrenal kitlelerin (insidentalomaların) görülmesine neden olmaktadır. Sürrenal İnsidentaiomalarımn hor-monal hİpersekresyon göstermesi veya maligniteyc dönüşümleri gibi doğal seyri ve riski halen araştırılmaktadır. Son 5 yıl içinde servisimizde sürrenal insi den talomalı 22 hasta tetkik edilmiş ve bunların 12'sİ ameliyata verilmiştir. Diğer hastalar teşhisinden sonra 3 ay ile 5 yıl arasında polikliniğimizden izlenmişlerdir. İnsidenEalomalar arasında biyokimyasal testler aracılığıyla, 2 hastada sessiz Cushing sendromıı (% 16.6), 3 hastada sessiz feokromositoma (%25) vc 17 hastada fonksiyone etmeyen adrenal kitlesi (%55A) tespit edilmiştir. Diğer hastaların hiçbirinde malignitc tespit edilmemiş, sadece birinde lakip sırasında kitle büyümüştür. Ameliyat edilen 12 hastanın histolojik tetkiklerinde. 3'ünde selim feokromositorna, 2'sİnde Cushing sendromu (birinde adenom diğerinde bilateral makronodüler hiperplazi), birinde leiomiyomatosis, 4'ünde adrenokortikal adenom, birinde kist tespit edilmiştir. Bu çalışma, en azından kısa bir sürede klinik olarak biyokimyasal bozukluklarla ortaya çıkmayan sürrenal insidentalomah bazı hastaların sessiz olarak hornıonal hiperfonks iyona maraz kalabileceğinin açık bir kanıtıdır. Bu vakalarda erken tanı hastalığın önlenmesini vc tedavisini sağlayacaktır
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