FARUK KILINÇ, Mazhar Müslüm TUNA, SEZGİN BARUTÇU, ZAFER PEKKOLAY, Hikmet SOYLU, Alpaslan Kemal TUZCU

Adrenal İnsidentalomalı 78 Hastanın Demografik ve Klinik Özellikleri

Adrenal insidentalomalar (AI); adrenal bezde herhangi bir hastalık kuşkusu yokken görüntüleme yöntemleri veya abdominal laparotomide tesadüfen saptanan kitlelerdir. Abdominal ultrasonografi, BT ve MR kullanımının artması ile adrenal insidentalomaların tespit edilme sıklığı da artmıştır. Bu çalışmamızda, AI nedeniyle takip edilen hastalarmızın demografik ve klinik verilerini sunmayı amaçladık. Bu çalışmaya 2007-2013 yılları arasında Dicle Üniversitesi Tıp Fakültesi Endokrinoloji Anabilim Dalı'na başvuran 78 hasta ( 53 kadın; 25 erkek) dahil edildi. Hasta dosyalarından hastalara ait fizik muayene, USG, BT sonuçları kaydedildi. Serum kortizolü, idrar metanefrini, idrar normetanefrini, idrar VMA, serum aldosteronu ve serum renin değerleri kaydedildi. Hastaların yaş ortalaması 48.6 ± 14.9 idi. Tespit edilen kitlelerin lokalizasyonu açısından anlamlı farklılık saptanmadı. Hastaların vücut kitle indeksi 28.54 ± 5.82 idi. 45 hastada (% 57.7) non-fonksiyonel adenom, 10 hastada (% 12.8) subklinik cushing, 11 hastada (% 14.1) feokromasitoma, 3 hastada (% 3.8) adrenal karsinom, 2 hastada (% 2.6) hiperaldosteronizm, 2 hastada (% 2.6) ganglionörom, 1 hastada (% 1.3) myelolipom, 1 hastada adrenal adenom, 1 hastada adrenal kist, 1 hastada schwannom ve 1 hastada da küçük yuvarlak hücreli tümör tespit edildi. Radyolojik görüntüleme sıklığı arttıkça adrenal insidentaloma olgularının sayısı da artmaktadır. Her adrenal insidentaloma, malign olup olmadığı ve hormonal işlevi olup olmadığı açısından değerlendirimelidir.

Clinical and Demographic Characteristics of 78 Patients with Adrenal Incidentaloma

Adrenal incidentalomas (AIs) are adrenal lesions detected on abdominal imaging procedures or abdominal laparotomy that had been performed for unrelated reasons. AIs have become a common clinical concern as a result of widespread use of abdominal ultrasound, CT and MR imaging in clinical practice. The aim of this study was to evaluate the demographical and clinical data our patients with AI. This study included data from 78 patients (53 female - 25 male) with AI those followed at Dicle University School of Medicine, Department of Endocrinology and Metabolism, between 2007 and 2013. Data collected from the records were physical and hormonal evaluation, diameter of the lesion, and the features of the lesion on radiological imaging. Also the results of serum cortisol, aldosterone, renin and 24 hour urinary metanephrine and normetanephrine were recorded. The average age of patients were 48.6 ±14.9 years. There was no significant difference in terms of localization of adenomas. Body mass ındex of patients were 28.54 ± 5.82. Of the patients, 45 (57.7%) were diagnosed as non-functional AI, 10 (12.8%) as subclinical Cushing's syndrome, 11 (14,1%) as pheochromocytoma, 2(2.6%) as primary hyperaldosteronism, and 3(3.8%) as adrenal carcinoma. Ganglioneuroma was stated in 2 patients (2.6%), myelolipoma was stated in 1 patient (1.3%), adrenal adenoma was stated in 1 patient, adrenal cyst was stated in 1 patient, schwannoma was stated in 1 patient and neoplasia with small circular cells was stated in 1 patients. AIs are currently more frequently detected in clinical practice due to increased use of imaging techniques. Although the vast majority of AIs are benign and non-functioning, appropriate hormonal evaluation and imaging procedures must be performed.

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