Suzan TABUR, Sadettin OZTURK, Onur AĞCABAY, Ersin AKARSU, Mustafa ARAZ

Surrenal Kitle Saptanan Hastaların Klinik, Labaratuar ve Radyolojik Bulguları; Tek Merkez Deneyimi

Amaç: Sürrenal insidentolamalar, başka nedenlerle yapılan görüntüleme testleri sırasında tesadüfen saptanan kitlelerdir. Günümüzde abdominal görüntüleme tekniklerinin yaygın olarak kullanılmaya başlanması ile birlikte sürrenal insidentaloma tanısının sıklığı artmıştır. Her adrenal insidentaloma, malign olup olmadığı ve hormonal işlevi olup olmadığı açısından değerlendirimelidir. Bu değerlendirme tedavi planlanması ve hastanın takibi için önemlidir.Materyal ve Metod: Toplam 68 sürrenal kitlesi olan vakanın klinik, radyolojik, hormonal ve labaratuvar takiplerini retrospektif değerlendirdik.Bulgular: Vakaların %58,8’i kadın (n:40), %41,2’si erkekti (n:28). Bu hastalardan 36’sı bilgisayarlı tomografi, 22’si bilgisayarlı tomografi ve manyetik rezonans görüntüleme, 10 tanesi de manyetik rezonans görüntüleme sonuçlarına göre değerlendirilmiştir. Adrenal insidentalomaların kitle çapı 4-95 mm idi. Adrenal insidentalomalı hastaların %42’si (n:29) opere edilmişti. Otuz beş hastada non-fonksiyone adenom(NFA) saptanırken, 33 hastada fonksiyonel adenom(FA) saptanmıştır. Klinikopatolojik değerlendirilmelerine göre surrenal kitlelerde 22 (%32,3) adet feokromositoma, 7 (%10,2) adet cushing sendromu ve 4(%1,4) adet conn sendromu saptanmıştır. Eşlik eden hastalıklar açısından değerlendirildiğinde; surrenal kitlesi olan hastalardan 15’inde (% 22,1) hipertansiyon ve diabetes mellitus, 26’sında (%38,2) diabetes mellitus, 27’sinde (%39,7) komorbidite olmadığı görüldü.Sonuç: Çalışmamızdaki adrenal insidentaloma vakalarının çoğu non-fonksiyone adenomdur. Fonksiyone adenomlar içinde klinik olarak en çok feokromositoma ve daha sonra ise cushing sendromu saptanmıştır. Adrenal kitlelerin cerrahiye gidişinde fonksiyonel olmaları ve boyutları belirleyicidir.

Anahtar Kelimeler:

sürrenal insidentaloma, feokromositoma, , Cushing sendromu, hiperaldosteronizm, sürrenal incidentaloma, pheochromocytoma, Cushing syndrome, hypereraldosteronism

Clinical, Laboratory and Radiological Findings of Patients with Surrenal Mass; Single Center Experience

Background: Adrenal inincidentolamas are masses that are incidentally detected during imaging tests performed for other reasons. Nowadays, with the wide spread use of abdominal imaging techniques, the frequency of adrenal incidentaloma diagnosis has increased. Every adrenal incidentaloma should be evaluated for whether it is malignant and hormonally functional. This evaluation is important for treatment planning and follow-up.Materials and Methods: We retrospectively evaluated the clinical, radiological, hormonal and laboratory follow-up of total 68 cases with adrenal masses.Results: 58.8% of the cases were female (n:40), 41.2% were male. Thirty six of the patients were evaluated according to the results of computerize tomography, 22 of the manyetic rezonans ımaging and computerize tomography, 10 of the manyetic rezonans imaging. The mass diameter of adrenal incidentalomas was 4-95 mm. 42% (n: 29) of the patients with adrenal incidentaloma were operated. Non-functional adenoma (NFA) was found in 35 patients, whereas functional adenoma (FA) was found in 33 patients. According to clinicopathological evaluations; 22 (32.3%) pheochromocytoma, 7 (10.2%) cushing syndrome and 4 (1.4%) conn syndrome were found in surrenal masses. When evaluated in terms of accompanying diseases; 15 of the patients had both hypertension and diabetes, 26 of the patients had diabetes and 27 of them had no comorbidities.Conclusions: Most of the adrenal incidentaloma cases in our study are non-functional adenomas. Among the functional adenomas, pheochromocytoma have been detected more commonly and this is followed by cushing syndrome. Functionality and size of them were decisive in the course of surgery.Key Words: Surrenal incidentaloma, Pheochromocytoma, Cushing syndrome, Hypereraldosteronism

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