Bir Olgu Sebebiyle Tek Taraflı Optik Atrofi Etiyolojisinde Hipofiz Adenomlarının Yeri

Ayşe Bozkurt Oflaz; Şansal Gedik; Banu Bozkurt; Banu Turgut Öztürk; Süleyman Okudan

Bir Olgu Sebebiyle Tek Taraflı Optik Atrofi Etiyolojisinde Hipofiz Adenomlarının Yeri

Year 2017, Volume: 27 Issue: 2, 76 - 79, 01.06.2017

Ayşe Bozkurt Oflaz Şansal Gedik Banu Bozkurt Banu Turgut Öztürk Süleyman Okudan

Abstract

Hipofiz adenomları gerçek kapsül ihtiva etmeyen adenohipofizyel hücrelerden oluşan metastaz yapmayan neoplazilerdir. Hipofiz adenomları intrakraniyel kitlelerin %10-15'ini oluştururlar. En sık 3-6. dekadlarda görülürken, çocuklarda nadirdir. Hipofiz adenomları boyut olarak 1 cm’den küçük ise mikroadenom, 1 cm’den büyük ise makroadenom olarak sınıflandırılır. Mikroadenomların aksine makroadenomlar görsel semptomlara, görme alanı defektine ve hipofiz yetmezliğine sebep olabilir. Hipofiz makroadenomları, benign tümöral olgular olarak kabul edilseler de nörovasküler bası ve hipopituitarizm yoluyla klinik tabloyu kötüleştirebilirler. Optik sinire bası yapan tümor patofizyolojik olarak desendan optik atrofiye yol açabilir. Optik diskin atrofik görünümü hastanın görme keskinliğini ve görme kalitesini önemli derecede düşüren, bir takım klinik olaylar zincirinin son basamağı olarak karşımıza çıkan bir tablodur. Bu nedenle takip ve tedavide fikir sahibi olabilmek için optik atrofi ile karşılaşıldığında ayırıcı tanı yapmak, hasta için önem arz etmektedir. Biz bu olguda tek taraflı optik disk atrofisinden yola çıkılarak yapılan görüntüleme sayesinde tanı konulan makroadenom hastasını sunmayı amaçladık

Keywords

Makroadenom, Tek taraflı optik atrofi, Görme alanı defekti

References

Burrow GN, Wortzman G, Rewcastle NB, Holgate RC, Kovacs K. Microadenomas of the pituitary and abnormal sellar tomograms in an unselected autopsy series. N Engl J Med 1981;304:156-8.
Molitch ME. Pituitary incidentalomas. Endocrinol Metab Clin North Am 1997;26:725-40.
Davis JR, Farrell WE, Clayton RN. Pituitary tumours. Reproduction 2001;121:363-71.
Freda PU, Wardlaw SL, Post KD. Unusual causes of sellar/ parasellar masses in a large transsphenoidal surgical series. J Clin Endocrinol Metab 1996;81:3455-9.
Scheithauer BW, Jaap AJ, Horvath E,ve ark. Clinically silent corticotroph tumors of the pituitary gland. Neurosurgery 2000;47:723-9.
Soto-Ares G, Cortet-Rudelli C, Assaker R, ve ark. MRI protocol technique in the optimal therapeutic strategy of nonfunctioning pituitary adenomas. Eur J Endocrinol 2002;146:179-6.
Donovan LE, Corenblum B. The natural history of thepitui- tary incidentaloma. Arch Intern Med. 1995;155:181-3.
Reincke M, Allolio B, Saeger W, Menzel J, Winkelmann W. The ‘incidentaloma’ of the pituitary gland. Is neurosurgery required ?. JAMA 1990;263:2772-6.
Sanno N, Oyama K, Tahara S, Teramoto A, Kato Y. A sur- vey of pituitary incidentaloma in Japan. Eur J Endocrinol 2003;149:123-7.
Arafah BM, Nekl KE, Gold RS, Selman WR. Dynami- cs of prolactin secretion in patients with hypopituitarism and pituitary macroadenomas. J Clin Endocrinol Metab 1995;80:3507-12.
Schlechte JA. Clinical practice. Prolactinoma. N Engl J Med 2003;349:2035-41.
Kanski JJ, Bowling B. Clinical Ophthalmology. A Systema- tic Approach (7th ed). Elsevier 2011;816-27.
Hildebrand GD, Eggitt IR, Saunders D ve ark. BowTie Cup- ping: A New Sign of Chiasmal Compression. Arch Opht- halmol 2010;128:1625-6.
Miller NR, Newman NJ ve ark. Walshand Hoyt's Clinical Neuro-Ophthalmology (6th ed). Philadelphia;Lippincott Williams&Wilkins; 2005:1531-46.
Güngör K, Bekir NA. Optik atrofi. Gaziantep Tıp Dergisi 1999;1:42-45.
Yenice Ö, Kazokoğlu H, Cerman E. Hidroksiklorokin Reti- nopatisi. Turkiye Klinikleri J Ophthalmol 2004;13:45-8.

Year 2017, Volume: 27 Issue: 2, 76 - 79, 01.06.2017

Ayşe Bozkurt Oflaz Şansal Gedik Banu Bozkurt Banu Turgut Öztürk Süleyman Okudan

Abstract

Pituitary adenomas are benign neoplasias derived from adenopituitary cells and they don’t have real capsules. Pituitary adenomas constitute 10-15% of all intracranial tumors and they are often diagnosed between 3rdand 6thdecades, rarely seen in children. Pituitary adenomas smaller than 1cm diameter are called as “microadenoma”, otherwise called as “macroadenoma”. Macroadenomas more often could cause visual field defects, visual symptoms and pituitary gland failure than microadenomas. Although macroadenomas are thought to be benign neoplasias, they could cause serious complications related to hypopituitarism and neurovascular mass effect of the tumor to adjecent tissues. Descending optic atrophy could be seen finally because of the pressure effect of pituitary adenoma on optic nerve. Atrophy of the optic nerve could be seen at the end step of pathologic progression of the disease ending with visual loss and visual acquity loss. Therefore differantial diagnosis of optic atrophy is crucial for early diagnosis and management of the patients with macroadenomas. We aimed to present a case with optic atrophy who is eventually diagnosed with pituitary macroadenoma in further radiological imaging

Keywords

Macroadenoma, Unilateral optic atrophy, Visual field defect

References

Burrow GN, Wortzman G, Rewcastle NB, Holgate RC, Kovacs K. Microadenomas of the pituitary and abnormal sellar tomograms in an unselected autopsy series. N Engl J Med 1981;304:156-8.
Molitch ME. Pituitary incidentalomas. Endocrinol Metab Clin North Am 1997;26:725-40.
Davis JR, Farrell WE, Clayton RN. Pituitary tumours. Reproduction 2001;121:363-71.
Freda PU, Wardlaw SL, Post KD. Unusual causes of sellar/ parasellar masses in a large transsphenoidal surgical series. J Clin Endocrinol Metab 1996;81:3455-9.
Scheithauer BW, Jaap AJ, Horvath E,ve ark. Clinically silent corticotroph tumors of the pituitary gland. Neurosurgery 2000;47:723-9.
Soto-Ares G, Cortet-Rudelli C, Assaker R, ve ark. MRI protocol technique in the optimal therapeutic strategy of nonfunctioning pituitary adenomas. Eur J Endocrinol 2002;146:179-6.
Donovan LE, Corenblum B. The natural history of thepitui- tary incidentaloma. Arch Intern Med. 1995;155:181-3.
Reincke M, Allolio B, Saeger W, Menzel J, Winkelmann W. The ‘incidentaloma’ of the pituitary gland. Is neurosurgery required ?. JAMA 1990;263:2772-6.
Sanno N, Oyama K, Tahara S, Teramoto A, Kato Y. A sur- vey of pituitary incidentaloma in Japan. Eur J Endocrinol 2003;149:123-7.
Arafah BM, Nekl KE, Gold RS, Selman WR. Dynami- cs of prolactin secretion in patients with hypopituitarism and pituitary macroadenomas. J Clin Endocrinol Metab 1995;80:3507-12.
Schlechte JA. Clinical practice. Prolactinoma. N Engl J Med 2003;349:2035-41.
Kanski JJ, Bowling B. Clinical Ophthalmology. A Systema- tic Approach (7th ed). Elsevier 2011;816-27.
Hildebrand GD, Eggitt IR, Saunders D ve ark. BowTie Cup- ping: A New Sign of Chiasmal Compression. Arch Opht- halmol 2010;128:1625-6.
Miller NR, Newman NJ ve ark. Walshand Hoyt's Clinical Neuro-Ophthalmology (6th ed). Philadelphia;Lippincott Williams&Wilkins; 2005:1531-46.
Güngör K, Bekir NA. Optik atrofi. Gaziantep Tıp Dergisi 1999;1:42-45.
Yenice Ö, Kazokoğlu H, Cerman E. Hidroksiklorokin Reti- nopatisi. Turkiye Klinikleri J Ophthalmol 2004;13:45-8.

There are 16 citations in total.

Details

Primary Language	Turkish
Journal Section	Case Report
Authors	Ayşe Bozkurt Oflaz This is me Şansal Gedik This is me Banu Bozkurt This is me Banu Turgut Öztürk This is me Süleyman Okudan This is me
Publication Date	June 1, 2017
Published in Issue	Year 2017 Volume: 27 Issue: 2

Cite

Vancouver	Bozkurt Oflaz A, Gedik Ş, Bozkurt B, Öztürk BT, Okudan S. Bir Olgu Sebebiyle Tek Taraflı Optik Atrofi Etiyolojisinde Hipofiz Adenomlarının Yeri. Genel Tıp Derg. 2017;27(2):76-9.