Murat ÇAKIR, Faruk AKSOY, Ebubekir GÜNDEŞ, Halil İbrahim TAŞCI, Ahmet TEKİN

Nadir Görülen Bir Tümör Feokromasitoma; Tek Merkez Deneyimi

AMAÇ: Nöroektodermal orijinli nadir bir tümör olan Feokromasitomalı olgulardaki klinik deneyimlerimizi gözden geçirmektir.YÖNTEMLER: 2005 ve 2012 yılları arasında kliniğimizde feokromasitoma tanısı konmuş 14 hastanın klinik, laboratuar, radyolojik ve cerrahi verileri geriye dönük olarak değerlendirilmiştir. BULGULAR: Kliniğimizde feokromasitoma tanısı ile tedavi gören 14 hastanın 8’i erkek, 6’sı kadın olup yaşları 18 ve 60 arasında değişmekte idi. Hastaların 10 %71 ’unda hipertansiyon mevcuttu. En sık semptom karın ağrısı %57 idi. Yerleşim yerleri açısından sekizi %57 solda, beşi %35 sağ ve birinde %7 tümör bilateral adrenal yerleşimliydi. Tanıda kullanılan görüntüleme yöntemi ultrasonografisi ve bilgisayarlı tomografiydi. Hastalarımızın hiç birisinde ailesel feokromasitoma sendromu ile ilişkili değildi. Bütün hipertansif hastalara preoperatif fenoksibenzamin ve propranolol verildi. Cerrahi işlem dokuz olguda laparoskopik, beşinde ise laparotomi ile gerçekleştirildi. Hipertansif hastaların % 80’inde cerrahi sonrasında remisyon gözlendi. İki hastada malign feokromasitoma tespit edildi. Tüm hastaların takibi 24 saatlik idrarda VMA düzeyi ve batın BT ile düzenli olarak yapıldı. Takiplerde olguların birinde karaciğer metastazı tespit edildi.SONUÇ: Bu çalışma ile feokromasitomanın nonspesifik ve değişken bir kliniğinin olduğu gösterilmek istendi. Sıklıkla tümör rastlantısal olarak bulunmaktadır. Feokromasitoma nadir bir tümör olmasına rağmen, doğru bir değerlendirme, iyi bir preoperatif hazırlık ve tam cerrahi eksizyon ile tedavi edilebilir.

Anahtar Kelimeler:

Adrenal kitle, nöroektodermal tümör, feokromasitoma

Pheochromocytoma Is A Rare Tumor; Single Center Experience

OBJECTIVE: The aim of our study is to review our clinical experiences with pheochromocytoma cases which are rare tumors with neuroectodermal origins.METHODS: The clinical, lab, radiological, and surgical data of a total of 14 patients diagnosed with pheochromocytoma between 2005 and 2012 at our clinic were evaluated retrospectively.RESULTS: Eight out of 14 patients who received treatment at our clinic having been diagnosed with pheochromocytoma were male, while 6 were female and their ages ranged between 18 and 60. 10 71% of the patients had hypertension. The most frequent symptom was abdominal pain 57% . Eight tumors were located on the left 57% and five were located on the right 35% , while one tumor 7% had bilateral adrenal location. The imaging techniques used in diagnosis were ultrasonography and computerized tomography. None of our patients had a history of familial pheochromocytoma. All the hypertensive patients were administered pre-op phenoxybenzamine and propranolol. The surgical procedures were performed by laparoscopy in nine cases, and by laparotomy in five. Post-op remission was observed in 80% of the hypertensive patients. Malign pheochromocytoma was detected in two patients. The follow-up of all the patients was conducted through testing the VMA level in 24-hour urine and through abdominal CT regularly. The follow-ups revealed that one case had liver metastasis.CONCLUSION: This study aims at demonstrating that pheochromocytoma has a non-specific and unstable clinic. The tumor is frequently found randomly. Although pheochromocytoma is a rare tumor, it can be treated through a right evaluation, good pre-op preparation, and complete surgical excision.

Keywords:

Adrenal mass, neuroectodermal tumor, pheochromocytoma,

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