Berat Cem ÖZGÜR, Haşmet SARICI, Muzaffer EROĞLU, Halil BAŞAR, Fatih HIZLI, Övünç BİLGİN, Özer GÜZEL, Yılmaz ASLAN, Ali ATAN

How radiologic and per-operative findings before radical nephrectomy would guide us for performing ipsilateral adrenalectomy?

Amaç: Adrenal bez tutulumunu öngörebilmek için preoperatif radyolojik görüntüleme bulguları, peroperatif muayene bulguları ile postoperatif patolojik bulguları değerlendirmeyi amaçladık. Gereç ve Yöntemler: 2005-2012 yılları arasında, üç farklı merkezde, böbrek hücreli kanser tanısı almış ve radikal nefrektomi ile birlikte aynı taraflı adrenalektomi yapılan 69 hasta değerlendirildi. Tüm hastaların demografik bulguları ve preoperatif tüm abdomen bilgisayarlı tomografi (BT) görüntülerindeki tümör boyutu, tarafı, yerleşimi kayıt edildi. Hastalar; operasyon öncesi BT deki adrenal bezin durumu, peroperatif palpasyon bulguları ve operasyon sonrası histopatolojik incelemedeki adrenal bez tutulumu açısından değerlendirildi. Bulgular: Olguların 25 i (%36,2) kadın ve 44 ü (%63,8) erkek olup ortalama yaşları sırasıyla 59.7±12.4 (39-81) ve 58.2±11.9 (37-80) yıl idi. Ortalama tümör boyutu 7.9±3 cm (2.4-16 cm) idi. Preoperatif BT raporlarında 6 olguda (%8,6) adrenal bez tutulumunu düşündürecek bulgular mevcuttu. Bu 6 hastada BT görüntü- lemesinde adrenal bezde yüzey düzensizliği ve nodüler formasyonu olarak tarif edilen olası tutulum bulguları mevcuttu. Altı hastanın 3 ünde peroperatif palpasyon ile yapılan muayenede adrenal tutulum bulguları mevcuttu. Bu hastaların histopatolojik incelemelerinde de adrenal bezde patolojik olarak tümör tespit edildi. Bir hastada

Radikal nefrektomi öncesi radyolojik ve peroperatif bulgular aynı taraflı adrenalektomi yapmak için bize ne kadar yol göstericidir?

Abstract Aim: The aim of this study is to evaluate the role of pre-operative radiologic imaging findings, per-operative findings, and post-operative pathological examination in the prediction of adrenal gland involvement. Material and Methods: Between 2005 and 2012, from 3 different hospitals, medical records of 69 patients who had radical nephrectomy with ipsilateral adrenalectomy for renal cell carcinoma were reviewed. Demographic data and preoperative abdominal computerized tomography (CT) findings including size, side and localization of the tumor were recorded. Pre-operative condition of the adrenal gland in CT, per-operative palpation findings, and post-operative histopathological examination were evaluated. Results: 25 patients (36.2%) were female and 44 (63.8%) were male with a mean age of 59.7 ± 12.4 (39-81) and 58.2 ± 11.9 (37-80) years, respectively. Mean tumor size was 7.9 ± 3 cm (2.4-16). In 6 cases (8.6%), we have found an evidence suggesting adrenal gland involvement in pre-operative CT. These six patients had possible signs of adrenal involvement in CT, described as irregular surface and nodule formation. The three of six patients had signs of adrenal involvement on per-operative palpation. In histopathological examination of these patients, tumor involvement was detected in adrenal gland. In one patient tumor involvement in adrenal gland was detected without preoperative CT findings

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