Zeynep Ebru ESER, Ramazan GEN, Kadir ESER, Kerem SEZER, Esen AKBAY

Adrenal insidentaloma’lı hastalarda klinik, biyokimyasal ve radyolojik retrospektif analiz

Giriş: Bu çalışmada, adrenal insidentaloma nedeniyle takip edilen hastaların epidemiyolojik, demografik, klinik özellikleri, tedavi yaklaşımları ve yaşam sürelerinin değerlendirilmesi amaçlanmıştır. Yöntem: 2010–2014 yılları arasında Mersin Üniversitesi Araştırma ve Uygulama Hastanesi Endokrinoloji Bölümünde adrenal insidentaloma nedeniyle tedavi ve takipleri yapılan 46 hastanın verileri retrospektif olarak incelendi. Bulgular: Çalışmaya alınan olguların 13’ü erkek, 33’ü kadın ve yaş ortalaması 54.09±10.7 idi. En sık başvuru nedeni %34.78 hastada karın ağrısı, en sık tanı konulan radyolojik yöntem % 60.87 dinamik sürrenal BT, en sık yerleşim yeri sol surrenal bezdi. Kitle çapı ortalama 26.8±16.5 mm arasında idi. Hipertansiyon sıklığı %50, obezite sıklığı %47.8, tip 2 diyabet sıklığı %21.7, osteoporoz sıklığı ise %42.8 ve metabolik sendrom sıklığı %41.3 olarak saptandı. Hormonal değerlendirme sonuçlarına göre %82.61’inde fonksiyonsuz adrenal adenom (FAA), %15.21’inde subklinik Cushing sendromu (SCS), %2.1’inde aldesteronoma görüldü. Adrenalektomiye giden 8 olguda myelolipom, feokromasitoma ve adrenokortikal adenom tanısı konuldu. Bir hasta karaciğer yetmezliğinden exitus oldu. Hastaların takiplerinde hormonal aktivasyon ve lezyon boyutunda büyüme saptanmadı. Sonuç: AI’ların çok farklı patolojik ve radyolojik görünümler ile karşımıza çıkmasından dolayı demografik, etiyolojik, klinik, laboratuar ve radyolojik verilerin bir bütün olarak değerlendirilmesi tedavi ve takibinde önemlidir.

Anahtar Kelimeler:

Adrenal insidentaloma, subklinik cushing sendromu, fonksiyonsuz adrenal adenom, teşhis, tedavi

Clinical, biochemical and radiological retrospective analysis in patients with adrenal incidentaloma

Introduction: The aim of this study was to evaluate the epidemiological, demographic, clinical features, treatment approaches and survival of patients followed up for adrenal incidentaloma. Methods: The data of 46 patients who underwent treatment and follow-up for adrenal incidentaloma in Mersin University Health Research and Practice Hospital, Endocrinology Department between 2010 and 2014 were retrospectively analyzed. Results: The study group consisted of 13 male and 33 female patients. The mean age was 54.09 ± 10.7 years. The most common reason for admission was abdominal pain in 34.78% of patients, the most commonly diagnosed radiological method was 60.87% dynamic surrenal CT, and the most common localization was right surrenal gland. The mean diameter of the mass was 26.8±16.5 mm. The prevalence of hypertension was 50%, obesity was 47.8%, type 2 diabetes was 21.7%, osteoporosis was 42.8% and metabolic syndrome was 41.3%. According to the results of hormonal evaluation, 82.61% of the patients had dysfunctional adrenal adenoma (FAA), 15.21% of them had subclinical Cushing syndrome (SCS) and 2.1% of them had aldesteronoma. Myelolipoma, benign pheochromocytoma and adrenocortical adenoma were diagnosed in 8 patients who underwent adrenalectomy. One patient died due to liver failure. No hormonal activation and lesion size growth was detected in the follow-up of the patients. Conclusion: Because of the different pathological and radiological features of AI, it is important to evaluate demographic, etiological, clinical, laboratory and radiological data as a whole in treatment and follow-up.

Keywords:

Adrenal incidentaloma, subclinical Cushing syndrome, dysfunctional adrenal adenoma, diagnosis, treatment,

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