Nonfonksiyonel Hipofiz Adenomlarının Cerrahi Endikasyonları ve Yönetimi
Aktif hormon sekresyonu yapmayan hipofiz tümörleri nonfonksiyonel adenom olarakadlandırılmaktadır. Tüm hipofiz adenomları içerisindeki oranları %30-35’dir. Bunlarınekseriside (%80-90) gonodotropik adenomlar tarafından oluşturulmaktadır. Hastalargenellikle nörolojik semptomlar ya da hipofizer yetmezlik şeklinde klinik gösterirler.Nonfonksyonel adenomu bulunan hastaların tedavisindeki amaçlar; nörolojik semptomlarındüzeltilmesi, nükse müsaade etmeyecek şekilde mümkünse makroadenom dokusununtamamen çıkartılması ve normal hipofiz dokusunun basısı sonucu gelişen hormonalyetmezliğin yönetimidir.
___
- 1. Dekkers OM, Hammer S, de Keizer RJ, Roelfsema F, Schutte
PJ, Smit JW et al. The natural course of non-functioning
pituitary macroadenomas.Eur J Endocrinol. 2007
Feb;156(2):217-24.
2. Molitch ME. Nonfunctioning pituitary tumors and pituitary incidenta-
lomas.EndocrinolMetabClin North Am. 2008
Mar;37(1):151-71, xi.
3. Nawar RN, AbdelMannan D, Selman WR, Arafah BM.Pituitary
tumor apoplexy: a review. J IntensiveCareMed. 2008
Mar;23(2):75-90.
4. Dekkers OM, Pereira AM, Romijn JA. Treatment and follow-up
of clinicallynon-functioning pituitary macroadenomas.J Clin Endocrinol
Metab. 2008 Oct;93(10) 3717-26. Epub 2008 Aug 5.
5. Ceylan S, Anik I, Koc K, Ciftci E, Cabuk B. Endoscopic approach
to cavernous sinus aneurysm.Turk Neurosurg.
2013;23(3):404-6.
6. Inder WJ, Hunt PJ. Glucocorticoid replacement in pituitary
surgery: guidelines for perioperative assessment and management.
J Clin Endocrinol Metab. 2002 Jun;87(6):2745-50.
7. Ausiello JC, Bruce JN, Freda PUPostoperative assessment of
the patient after transsphenoidal pituitary surgery.Pituitary.
2008;11(4):391
8. Adams JR, Blevins LS Jr, Allen GS, Verity DK, Devin JK. Disorders
of water me-tabolism following transsphenoidal pituitary
surgery: a single institution's experi-ence.Pituitary.
2006;9(2):93-9.
9. Murad MH, Fernández-Balsells MM, Barwise A, Gallegos-
Orozco JF, Paul A, Lane MA, et all. Outcomes of surgical treatment
for nonfunctioning pituitary adenomas: a systematic
review and meta-analysis.ClinEndocrinol (Oxf). 2010
Dec;73(6):777-91.
10. Woollons AC, Hunn MK, Rajapakse YR, Toomath R, Hamilton
DA, Conaglen JV, et all. Non-functioning pituitary adenomas:
indications for postoperative radiother-apy.Clin Endocrinol
(Oxf). 2000 Dec;53(6):713-7.
11. Tsang RW, Brierley JD, Panzarella T, Gospodarowicz MK,
Sutcliffe SB, Simpson WJ Radiation therapy for pituitary adenoma:
treatment outcome and prognostic fac-tors.Int J RadiatOncolBiolPhys.
1994;30(3):557.
12. McCord MW, Buatti JM, Fennell EM, Mendenhall WM, Marcus
RB Jr, Rhoton AL et all. Radiotherapy for pituitary adenoma:
long-term outcome and sequelae.Int J RadiatOncolBiolPhys.
1997;39(2):437.
13. van den Bergh AC, van den Berg G, Schoorl MA, Sluiter WJ,
van der Vliet AM, Hoving EW et all. Immediate postoperative
radiotherapy in residual nonfunctioning pituitary adenoma:
beneficial effect on local control without additional negative
im-pact on pituitary function and life expectancy.Int J
RadiatOncolBiolPhys. 2007;67(3):863.
14. Dekkers OM, Pereira AM, Romijn JA. Treatment and follow-up
of clinically non-functioning pituitary macroadenomas. J ClinEndocrinolMetab.
2008 Oct;93(10):3717-26. Epub 2008 Aug 5.
15. Karavitaki N, Thanabalasingham G, Shore HC, Trifanescu R,
Ansorge O, Meston N, et all. Do the limits of serum prolactin
in disconnection hyperprolactinaemia need re-definition?
A study of 226 patients with histologically verified non-functioning
pituitary macroadenoma.Clin Endocrinol (Oxf). 2006
Oct;65(4):524-9.