Clinical, hormonal, radiological and morphological comparison of patients with clinically evident Cushing's disease and patients with silent corticotroph cell adenoma

Year 2020, Volume: 45 Issue: 4, 1720 - 1732, 27.12.2020

Gamze Akkuş Baris Karagün Nuri Eralp Çetinalp Arbil Açıkalın Fulya Odabaş Mehtap Evran Olgun Murat Sert Suzan Zorludemir Bekir Tamer Tetiker

https://doi.org/10.17826/cumj.783225

Cited By: 1

Abstract

Purpose: The aim of the study was to review our clinical 7 years experiences with silent corticotroph adenoma (SCA) and Cushing disease (CD) with regard to clinical, radiological features, immunohistochemical and surgical outcomes and compare the results between two groups.
Material and Methods: We retrospectively reviewed a series of patients (n=17; SCA 10, CD 7) with corticotroph adenomas and collected biochemical, neuroradiological and pathological data of those during follow-up time.
Results: Mean pre-operative ACTH values of the patients with CD and SCA were 60.4±29.5, 45.5±34.6 pg/mL, respectively. Mean preoperative cortisol of the patient with CD (21.2±4.4 vs 11.5±4.0 mcg/dL) was increased than the patients with SCA measurements’. Patients with SCA had larger pituitary mass (20.4±4.5 vs 8.8±4.0 mm) than the patients with CD. And cavernous sinus invasion also was determined in all patients with SCA. Sparsely granulation staining was more common in all patients with SCA (7/10) or CD (4/7).
Conclusion: SCAs are totally different from functional CD adenomas related with clinical characteristics and postoperative outcomes. SCA can be thought of as a diverse group of pituitary adenomas.

Keywords

pituitary adenomas, silent corticotroph adenomas, clinical comparison

Klinik olarak belirgin Cushing hastalığı olan hastalar ile sessiz kortikotrof hücreli adenomu olan hastaların klinik, hormonal, radyolojik ve morfolojik olarak karşılaştırılması

Abstract

Amaç: Bu çalışmada retrospektif olarak kendi kliniğimizde takip edilen sessiz kortikotrof adenomu (SKA) olan hastalar ile belirgin kortizol sekrete eden adenomu (Cushing Hastalığı (CH)) olan hastaları klinik, radyolojik, immunohistokimyasal ve cerrahi sonuçlarına göre karşılaştırılması amaçlanmıştır.
Gereç ve Yöntem: Retrospektif olarak takip edilmiş 17 hastanın 10 tanesi SKA; diğer 7 tanesi aşikar CH olan bireyleri klinik, biyokimyasal, nöroradyolojik ve patolojik verilerine göre toplayıp karşılaştırdık.
Bulgular: CH olan hastalar ile SKA’sı olan hastaların preoperatif ACTH değerleri (60.4±29.5, 45.5±34.6 pg/mL) birbirine benzer olup, preoperatif kortizol değerleri (21.2±4.4 vs 11.5±4.0 mcg/dL) arasında anlamlı farklılık vardı. SKA’sı olan hastaların ortalama hipofiz adenom boyutları (20.4±4.5 mm), CH olan bireylerin ortalama adenom boyutlarından (8.8±4.0 mm) daha fazla idi. Aynı şekilde kavernöz sinüs invazyonu SKA’sı olan hastalarda daha fazla görülmekte idi. Her iki grupta immunohistokimyasal olarak seyrek granüllü boyanma paterni (SKA 7/10, CH 4/7) daha fazla görülmekte idi.
Sonuç: Sessiz kortikotrof adenomlar klinik ve postoperatif sonuçları itibari ile aşikar CH olan bireylerden tamamı ile farklıdır. Bu yönü ile sessiz kortikotrof adenomları pituiter adenomların farklı bir sub-grubu gibi değerlendirmek daha doğru olacaktır.

Keywords

sessiz kortikotrof adenomlar, pituiter adenomlar, immunohistokimyasal boyanma

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