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Tek Merkez Deneyimi: Feokromasitoma Olgularının Retrospektif Değerlendirilmesi

Year 2021, Volume: 11 Issue: 3, 353 - 359, 01.12.2021

Murat Çalapkulu Muhammed Erkam Sencar İlknur Östürk Ünsal Davut Sakız Mustafa Özbek Erman Çakal

Abstract

Amaç: Feokromositomalar kromaffin hücrelerinden kaynaklanan nöroendokrin tümörlerdir. Bu çalışmanın amacı feokromasitoma hastalarının klinik, laboratuvar ve görüntüleme bulgularını gözden geçirmektir.
Materyal ve Metot: Araştırmamızda 2009–2019 yılları arasında feokromasitoma tanısı almış 19 olguya ait klinik, laboratuvar ve radyolojik veriler geriye dönük olarak değerlendirilmiştir.
Bulgular: Feokromasitoma tanısı konan 19 hastadan 13’ü kadın, 6’sı erkek olup ortalama yaş 44,1±11,3 yıl olarak saptandı. Hastaların 8 tanesi yeni tanı olmak üzere 18’inde hipertansiyon
mevcuttu. Feokromositoma hastalarına eşlik eden hastalıklar incelendiğinde, hipertansiyondan sonra en sık tiroid patolojilerinin olduğu bulundu. Tansiyon yüksekliğinden sonra en sık semptom
terleme ve baş ağrısı olarak saptandı. Tüm hastalarda vitamin D eksikliği ya da yetersizliği mevcuttu. Hastaların %94,1’inde 24 saatlik idrarda bakılan normetanefrin düzeyi yüksek olarak saptandı. Yerleşim yerleri açısından on birinde sağda, beşinde solda ve üçünde tümör bilateral adrenal yerleşimliydi. Lezyon boyutu %36,8’inde 4 cm’den küçük, %42,1’inde 4–6 cm arasında saptanırken,
%21,1’inde 6 cm’den büyük saptandı.
Sonuç: Bu çalışma feokromasitomanın nonspesifik ve değişken bir kliniğinin olduğunu gösterdi. Feokromasitoma şüphesi olan hastalarda özellikle ataklar sırasında tarama testi olarak 24 saatlik
idrarda normetanefrin ve metanefrin düzeyleri istenmeli ve görüntüleme yöntemleri ile kitle lokalize edildikten sonra cerrahi tedavi uygulanmalıdır.

Keywords

feokromasitoma hipertansiyon; katekolamin; semptomlar; tanı; vitamin D

References

  • 1. Lenders JWM, Duh Q-Y, Eisenhofer G, et al. Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2014;99(6):1915–42.
  • 2. Feokromositoma. Adrenal ve Gonadal Hastalıklar Kılavuzu. Türkiye Endokrinoloji ve Metabolizma Derneği, 7. Baskı, Miki Matbaacılık San. ve Tic. Ltd. Şti., Ankara, 2019;47–64.
  • 3. Beard CM, Sheps SG, Kurland LT, Carney JA, Lie JT. Occurrence of pheochromocytoma in Rochester, Minnesota, 1950 through 1979. Mayo Clin Proc 1983;58(12):802–4.
  • 4. Pacak K, Linehan WM, Eisenhofer G, Walther MM, Goldstein DS. Recent advances in genetics, diagnosis, localization, and treatment of pheochromocytoma. Ann Intern Med 2001;134(4):315–29.
  • 5. Stein PP, Black HR. A simplified diagnostic approach to pheochromocytoma. A review of the literature and report of one institution’s experience. Medicine (Baltimore)1991;70(1):46–66.
  • 6. Guerrero MA, Schreinemakers JMJ, Vriens MR, et al. Clinical spectrum of pheochromocytoma. J Am Coll Surg 2009;209(6):727–32.
  • 7. Else T. 15 Years of Paraganglioma. Pheochromocytoma, paraganglioma and genetic syndromes: a historical perspective. Endocr Relat Cancer 2015;22(4): T147–159.
  • 8. Paul A, Fitzgerald MD. Adrenal medulla and paraganglia. In: Gardner DG, Shoback D (eds) Greenspan’s Basic and ClinicalEndocrinology 9th edition. USA. McGraw Hill companies; 2011 358–93.
  • 9. Eisenhofer G, Siegert G, Kotzerke J, Bornstein SR, Pacak K. Current progress and future challenges in the biochemical diagnosis and treatment of pheochromocytomas and paragangliomas. Horm Metab Res Horm Stoffwechselforschung Horm Metab 2008;40(5):329–37.
  • 10. Tsunoda M. Recent advances in methods for the analysis of catecholamines and their metabolites. Anal Bioanal Chem 2006;386(3):506–14.
  • 11. Sinan Aydoğdu, Kerim Güler, Fahri Bayram, Bülent Altun, Ülver Derici, Adnan Abacı, Tufan Tükek, Tevfik Sabuncu et al 2019 Turkish Hypertension Consensus Report. Turk Kardiyol Dern Ars 2019;47(6):535–546.
  • 12. Cheng L-F, Tseng S-C, Yu C-C, et al. Pheochromocytoma: A single-center 20-year experience. Urol Sci 2019;30(1):30.
  • 13. Karagiannis A, Mikhailidis DP, Athyros VG, Harsoulis F. Pheochromocytoma: an update on genetics and management. Endocr Relat Cancer 2007;14(4):935–56.
  • 14. Parikh PP, Rubio GA, Farra JC, Lew JI. Nationwide review of hormonally active adrenal tumors highlights high morbidity in pheochromocytoma. J Surg Res 2017;215:204–10.
  • 15. Soufi M, Bouziane M, Azzouzi A, Housni B, Elharroudi T. Graves disease allied with multiple pheochromocytoma. Indian J Endocrinol Metab 2013;17(2):323.
  • 16. Nasser T, Qari F. Pheochromocytoma, papillary thyroid carcinoma. Saudi Med J 2009;30(8):1087–90.
  • 17. Furmaniuk A, Demarquet L, Klein M, Weryha G, Feigerlova E. Subacute Thyroiditis Revealing a Pheochromocytoma. AACE Clin Case Rep 2016;2(2): e161–6.
  • 18. Serin SO, Güçlü M, Ersoy C, Ayar K, Bal Ö, İmamoğlu Ş 10 Yıllık Feokromasitoma Deneyimi ve Literatüre Bakış. Uludağ Üniversitesi Tıp Fakültesi Derg 2009;35(1):11–6.
  • 19. Rossi GP, Seccia TM, Pessina AC. Clinical use of laboratory tests for the identification of secondary forms of arterial hypertension. Crit Rev Clin Lab Sci 2007;44(1):1–85.
  • 20. Malindretos PM, Sarafidis PA, Geropoulou EZ, Kapoulas S, Paramythiotis DD, Lasaridis AN. Sustained Hypotension Complicating an Extra-adrenal Pheochromocytoma. Am J Hypertens 2008;21(7):840–2.
  • 21. Latronico AC, Chrousos GP. Extensive personal experience: adrenocortical tumors. J Clin Endocrinol Metab 1997;82(5):1317–24.
  • 22. Neumann HPH, Pawlu C, Peczkowska M, et al. Distinct clinical features of paraganglioma syndromes associated with SDHB and SDHD gene mutations. JAMA 2004;292(8):943–51.
  • 23. Manger WM, Gifford RW. Pheochromocytoma. J Clin Hypertens Greenwich Conn 2002;4(1):62–72.
  • 24. Amar L, Servais A, Gimenez-Roqueplo A-P, Zinzindohoue F, Chatellier G, Plouin P-F. Year of diagnosis, features at presentation, and risk of recurrence in patients with pheochromocytoma or secreting paraganglioma. J Clin Endocrinol Metab 2005;90(4):2110–6.
  • 25. Bravo EL. Pheochromocytoma: new concepts and future trends. Kidney Int 1991;40(3):544–56.
  • 26. Bravo EL, Gifford RW. Pheochromocytoma. Endocrinol Metab Clin North Am 1993;22(2):329–41.
  • 27. Baguet J-P, Hammer L, Mazzuco TL, et al. Circumstances of discovery of phaeochromocytoma: a retrospective study of 41 consecutive patients. Eur J Endocrinol 2004;150(5):681–6.
  • 28. Falchetti A, Marini F, Luzi E, Tonelli F, Brandi ML, Brandt ML. Multiple endocrine neoplasms. Best Pract Res Clin Rheumatol 2008;22(1):149–63.
  • 29. Carling T. Multiple endocrine neoplasia syndrome: genetic basis for clinical management. Curr Opin Oncol 2005;17(1):7–12.
  • 30. Stewart AF, Hoecker JL, Mallette LE, Segre GV, Amatruda TT, Vignery A. Hypercalcemia in pheochromocytoma. Evidence for a novel mechanism. Ann Intern Med 1985;102(6):776–9.
  • 31. Edafe O, Webster J, Fernando M, Vinayagam R, Balasubramanian SP. Phaeochromocytoma with hypercortisolism and hypercalcaemia. BMJ Case Rep 2015;2015: bcr2014208657.
  • 32. Takeda K, Hara N, Kawaguchi M, Nishiyama T, Takahashi K. Parathyroid hormone-related peptide-producing non-familial pheochromocytoma in a child. Int J Urol Off J Jpn Urol Assoc 2010;17(7):673–6.
  • 33. Tepede AA, Welch J, Lee M, et al 18F-FDOPA PET/CT accurately identifies MEN1-associated pheochromocytoma. Endocrinol Diabetes Metab Case Rep 2020;2020.
  • 34. Cetani F, Saponaro F, Borsari S, Marcocci C. Familial and Hereditary Forms of Primary Hyperparathyroidism. Front Horm Res 2019;51:40–51.
  • 35. Giovannucci E. The epidemiology of vitamin D and cancer incidence and mortality: a review (United States). Cancer Causes Control CCC 2005;16(2):83–95.
  • 36. Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr 2007;85(6):1586–91.
  • 37. Shahbaz A, Aziz K, Fransawy Alkomos M, Nabi U, Zarghamravanbakhsh P, Sachmechi I. Pheochromocytoma Secreting Large Quantities of Both Epinephrine and Norepinephrine Presenting with Episodes of Hypotension and Severe Electrolyte Imbalance. Cureus [Internet] 2018 [cited 2020 Jun 29]; Available from: https://www.cureus.com/ articles/13180-pheochromocytoma-secreting-large-quantitiesof-both-epinephrine-and-norepinephrine-presenting-withepisodes- of-hypotension-and-severe-electrolyte-imbalance
  • 38. Alface MM, Moniz P, Jesus S, Fonseca C. Pheochromocytoma: clinical review based on a rare case in adolescence. BMJ Case Rep 2015;2015.
  • 39. Satman I, Omer B, Tutuncu Y, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013;28(2):169–80.
  • 40. Lenders JWM, Pacak K, Walther MM, et al. Biochemical Diagnosis of Pheochromocytoma: Which Test Is Best? JAMA [Internet] 2002 [cited 2020 Jun 29];287(11). Available from: http://jama.jamanetwork.com/article.aspx?doi=10.1001/ jama.287.11.1427
  • 41. Perry CG, Sawka AM, Singh R, Thabane L, Bajnarek J, Young WF. The diagnostic efficacy of urinary fractionated metanephrines measured by tandem mass spectrometry in detection of pheochromocytoma. Clin Endocrinol (Oxf )2007;66(5):703–8.
  • 42. Sawka AM, Jaeschke R, Singh RJ, Young WF. A comparison of biochemical tests for pheochromocytoma: measurement of fractionated plasma metanephrines compared with the combination of 24-hour urinary metanephrines and catecholamines. J Clin Endocrinol Metab 2003;88(2):553–8.
  • 43. Bravo EL. Evolving concepts in the pathophysiology, diagnosis, and treatment of pheochromocytoma. Endocr Rev 1994;15(3):356–68.
  • 44. Ilias I, Sahdev A, Reznek RH, Grossman AB, Pacak K. The optimal imaging of adrenal tumours: a comparison of different methods. Endocr Relat Cancer 2007;14(3):587–99.
  • 45. Sohail S, Shafiq W, Raza SA, Zahid A, Mir K, Azmat U. Clinical Characteristics and Outcome of Patients With Pheochromocytoma: A Single Center Tertiary Care Experience. Cureus [Internet] 2020 [cited 2020 Jun 30];Available from: https://www. cureus. com/articles/29967- clinical-characteristics-and-outcome-of-patients-withpheochromocytoma- a-single-center-tertiary-care experience
  • 46. Falhammar H, Kjellman M, Calissendorff J. Initial clinical presentation and spectrum of pheochromocytoma: a study of 94 cases from a single center. Endocr Connect 2018;7(1):186–92.
  • 47. Conzo G, Gambardella C, Candela G, et al. Single center experience with laparoscopic adrenalectomy on a large clinical series. BMC Surg 2018;18(1):2.

Year 2021, Volume: 11 Issue: 3, 353 - 359, 01.12.2021

Murat Çalapkulu Muhammed Erkam Sencar İlknur Östürk Ünsal Davut Sakız Mustafa Özbek Erman Çakal

Abstract

References

  • 1. Lenders JWM, Duh Q-Y, Eisenhofer G, et al. Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2014;99(6):1915–42.
  • 2. Feokromositoma. Adrenal ve Gonadal Hastalıklar Kılavuzu. Türkiye Endokrinoloji ve Metabolizma Derneği, 7. Baskı, Miki Matbaacılık San. ve Tic. Ltd. Şti., Ankara, 2019;47–64.
  • 3. Beard CM, Sheps SG, Kurland LT, Carney JA, Lie JT. Occurrence of pheochromocytoma in Rochester, Minnesota, 1950 through 1979. Mayo Clin Proc 1983;58(12):802–4.
  • 4. Pacak K, Linehan WM, Eisenhofer G, Walther MM, Goldstein DS. Recent advances in genetics, diagnosis, localization, and treatment of pheochromocytoma. Ann Intern Med 2001;134(4):315–29.
  • 5. Stein PP, Black HR. A simplified diagnostic approach to pheochromocytoma. A review of the literature and report of one institution’s experience. Medicine (Baltimore)1991;70(1):46–66.
  • 6. Guerrero MA, Schreinemakers JMJ, Vriens MR, et al. Clinical spectrum of pheochromocytoma. J Am Coll Surg 2009;209(6):727–32.
  • 7. Else T. 15 Years of Paraganglioma. Pheochromocytoma, paraganglioma and genetic syndromes: a historical perspective. Endocr Relat Cancer 2015;22(4): T147–159.
  • 8. Paul A, Fitzgerald MD. Adrenal medulla and paraganglia. In: Gardner DG, Shoback D (eds) Greenspan’s Basic and ClinicalEndocrinology 9th edition. USA. McGraw Hill companies; 2011 358–93.
  • 9. Eisenhofer G, Siegert G, Kotzerke J, Bornstein SR, Pacak K. Current progress and future challenges in the biochemical diagnosis and treatment of pheochromocytomas and paragangliomas. Horm Metab Res Horm Stoffwechselforschung Horm Metab 2008;40(5):329–37.
  • 10. Tsunoda M. Recent advances in methods for the analysis of catecholamines and their metabolites. Anal Bioanal Chem 2006;386(3):506–14.
  • 11. Sinan Aydoğdu, Kerim Güler, Fahri Bayram, Bülent Altun, Ülver Derici, Adnan Abacı, Tufan Tükek, Tevfik Sabuncu et al 2019 Turkish Hypertension Consensus Report. Turk Kardiyol Dern Ars 2019;47(6):535–546.
  • 12. Cheng L-F, Tseng S-C, Yu C-C, et al. Pheochromocytoma: A single-center 20-year experience. Urol Sci 2019;30(1):30.
  • 13. Karagiannis A, Mikhailidis DP, Athyros VG, Harsoulis F. Pheochromocytoma: an update on genetics and management. Endocr Relat Cancer 2007;14(4):935–56.
  • 14. Parikh PP, Rubio GA, Farra JC, Lew JI. Nationwide review of hormonally active adrenal tumors highlights high morbidity in pheochromocytoma. J Surg Res 2017;215:204–10.
  • 15. Soufi M, Bouziane M, Azzouzi A, Housni B, Elharroudi T. Graves disease allied with multiple pheochromocytoma. Indian J Endocrinol Metab 2013;17(2):323.
  • 16. Nasser T, Qari F. Pheochromocytoma, papillary thyroid carcinoma. Saudi Med J 2009;30(8):1087–90.
  • 17. Furmaniuk A, Demarquet L, Klein M, Weryha G, Feigerlova E. Subacute Thyroiditis Revealing a Pheochromocytoma. AACE Clin Case Rep 2016;2(2): e161–6.
  • 18. Serin SO, Güçlü M, Ersoy C, Ayar K, Bal Ö, İmamoğlu Ş 10 Yıllık Feokromasitoma Deneyimi ve Literatüre Bakış. Uludağ Üniversitesi Tıp Fakültesi Derg 2009;35(1):11–6.
  • 19. Rossi GP, Seccia TM, Pessina AC. Clinical use of laboratory tests for the identification of secondary forms of arterial hypertension. Crit Rev Clin Lab Sci 2007;44(1):1–85.
  • 20. Malindretos PM, Sarafidis PA, Geropoulou EZ, Kapoulas S, Paramythiotis DD, Lasaridis AN. Sustained Hypotension Complicating an Extra-adrenal Pheochromocytoma. Am J Hypertens 2008;21(7):840–2.
  • 21. Latronico AC, Chrousos GP. Extensive personal experience: adrenocortical tumors. J Clin Endocrinol Metab 1997;82(5):1317–24.
  • 22. Neumann HPH, Pawlu C, Peczkowska M, et al. Distinct clinical features of paraganglioma syndromes associated with SDHB and SDHD gene mutations. JAMA 2004;292(8):943–51.
  • 23. Manger WM, Gifford RW. Pheochromocytoma. J Clin Hypertens Greenwich Conn 2002;4(1):62–72.
  • 24. Amar L, Servais A, Gimenez-Roqueplo A-P, Zinzindohoue F, Chatellier G, Plouin P-F. Year of diagnosis, features at presentation, and risk of recurrence in patients with pheochromocytoma or secreting paraganglioma. J Clin Endocrinol Metab 2005;90(4):2110–6.
  • 25. Bravo EL. Pheochromocytoma: new concepts and future trends. Kidney Int 1991;40(3):544–56.
  • 26. Bravo EL, Gifford RW. Pheochromocytoma. Endocrinol Metab Clin North Am 1993;22(2):329–41.
  • 27. Baguet J-P, Hammer L, Mazzuco TL, et al. Circumstances of discovery of phaeochromocytoma: a retrospective study of 41 consecutive patients. Eur J Endocrinol 2004;150(5):681–6.
  • 28. Falchetti A, Marini F, Luzi E, Tonelli F, Brandi ML, Brandt ML. Multiple endocrine neoplasms. Best Pract Res Clin Rheumatol 2008;22(1):149–63.
  • 29. Carling T. Multiple endocrine neoplasia syndrome: genetic basis for clinical management. Curr Opin Oncol 2005;17(1):7–12.
  • 30. Stewart AF, Hoecker JL, Mallette LE, Segre GV, Amatruda TT, Vignery A. Hypercalcemia in pheochromocytoma. Evidence for a novel mechanism. Ann Intern Med 1985;102(6):776–9.
  • 31. Edafe O, Webster J, Fernando M, Vinayagam R, Balasubramanian SP. Phaeochromocytoma with hypercortisolism and hypercalcaemia. BMJ Case Rep 2015;2015: bcr2014208657.
  • 32. Takeda K, Hara N, Kawaguchi M, Nishiyama T, Takahashi K. Parathyroid hormone-related peptide-producing non-familial pheochromocytoma in a child. Int J Urol Off J Jpn Urol Assoc 2010;17(7):673–6.
  • 33. Tepede AA, Welch J, Lee M, et al 18F-FDOPA PET/CT accurately identifies MEN1-associated pheochromocytoma. Endocrinol Diabetes Metab Case Rep 2020;2020.
  • 34. Cetani F, Saponaro F, Borsari S, Marcocci C. Familial and Hereditary Forms of Primary Hyperparathyroidism. Front Horm Res 2019;51:40–51.
  • 35. Giovannucci E. The epidemiology of vitamin D and cancer incidence and mortality: a review (United States). Cancer Causes Control CCC 2005;16(2):83–95.
  • 36. Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr 2007;85(6):1586–91.
  • 37. Shahbaz A, Aziz K, Fransawy Alkomos M, Nabi U, Zarghamravanbakhsh P, Sachmechi I. Pheochromocytoma Secreting Large Quantities of Both Epinephrine and Norepinephrine Presenting with Episodes of Hypotension and Severe Electrolyte Imbalance. Cureus [Internet] 2018 [cited 2020 Jun 29]; Available from: https://www.cureus.com/ articles/13180-pheochromocytoma-secreting-large-quantitiesof-both-epinephrine-and-norepinephrine-presenting-withepisodes- of-hypotension-and-severe-electrolyte-imbalance
  • 38. Alface MM, Moniz P, Jesus S, Fonseca C. Pheochromocytoma: clinical review based on a rare case in adolescence. BMJ Case Rep 2015;2015.
  • 39. Satman I, Omer B, Tutuncu Y, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013;28(2):169–80.
  • 40. Lenders JWM, Pacak K, Walther MM, et al. Biochemical Diagnosis of Pheochromocytoma: Which Test Is Best? JAMA [Internet] 2002 [cited 2020 Jun 29];287(11). Available from: http://jama.jamanetwork.com/article.aspx?doi=10.1001/ jama.287.11.1427
  • 41. Perry CG, Sawka AM, Singh R, Thabane L, Bajnarek J, Young WF. The diagnostic efficacy of urinary fractionated metanephrines measured by tandem mass spectrometry in detection of pheochromocytoma. Clin Endocrinol (Oxf )2007;66(5):703–8.
  • 42. Sawka AM, Jaeschke R, Singh RJ, Young WF. A comparison of biochemical tests for pheochromocytoma: measurement of fractionated plasma metanephrines compared with the combination of 24-hour urinary metanephrines and catecholamines. J Clin Endocrinol Metab 2003;88(2):553–8.
  • 43. Bravo EL. Evolving concepts in the pathophysiology, diagnosis, and treatment of pheochromocytoma. Endocr Rev 1994;15(3):356–68.
  • 44. Ilias I, Sahdev A, Reznek RH, Grossman AB, Pacak K. The optimal imaging of adrenal tumours: a comparison of different methods. Endocr Relat Cancer 2007;14(3):587–99.
  • 45. Sohail S, Shafiq W, Raza SA, Zahid A, Mir K, Azmat U. Clinical Characteristics and Outcome of Patients With Pheochromocytoma: A Single Center Tertiary Care Experience. Cureus [Internet] 2020 [cited 2020 Jun 30];Available from: https://www. cureus. com/articles/29967- clinical-characteristics-and-outcome-of-patients-withpheochromocytoma- a-single-center-tertiary-care experience
  • 46. Falhammar H, Kjellman M, Calissendorff J. Initial clinical presentation and spectrum of pheochromocytoma: a study of 94 cases from a single center. Endocr Connect 2018;7(1):186–92.
  • 47. Conzo G, Gambardella C, Candela G, et al. Single center experience with laparoscopic adrenalectomy on a large clinical series. BMC Surg 2018;18(1):2.
There are 47 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Article
Authors

Murat Çalapkulu

Muhammed Erkam Sencar This is me

İlknur Östürk Ünsal This is me

Davut Sakız This is me

Mustafa Özbek This is me

Erman Çakal This is me

Publication Date December 1, 2021
Published in Issue Year 2021 Volume: 11 Issue: 3

Cite

APA Çalapkulu, M., Sencar, M. E., Östürk Ünsal, İ., Sakız, D., et al. (2021). Tek Merkez Deneyimi: Feokromasitoma Olgularının Retrospektif Değerlendirilmesi. Kafkas Journal of Medical Sciences, 11(3), 353-359.
AMA Çalapkulu M, Sencar ME, Östürk Ünsal İ, Sakız D, Özbek M, Çakal E. Tek Merkez Deneyimi: Feokromasitoma Olgularının Retrospektif Değerlendirilmesi. KAFKAS TIP BİL DERG. December 2021;11(3):353-359.
Chicago Çalapkulu, Murat, Muhammed Erkam Sencar, İlknur Östürk Ünsal, Davut Sakız, Mustafa Özbek, and Erman Çakal. “Tek Merkez Deneyimi: Feokromasitoma Olgularının Retrospektif Değerlendirilmesi”. Kafkas Journal of Medical Sciences 11, no. 3 (December 2021): 353-59.
EndNote Çalapkulu M, Sencar ME, Östürk Ünsal İ, Sakız D, Özbek M, Çakal E (December 1, 2021) Tek Merkez Deneyimi: Feokromasitoma Olgularının Retrospektif Değerlendirilmesi. Kafkas Journal of Medical Sciences 11 3 353–359.
IEEE M. Çalapkulu, M. E. Sencar, İ. Östürk Ünsal, D. Sakız, M. Özbek, and E. Çakal, “Tek Merkez Deneyimi: Feokromasitoma Olgularının Retrospektif Değerlendirilmesi”, KAFKAS TIP BİL DERG, vol. 11, no. 3, pp. 353–359, 2021.
ISNAD Çalapkulu, Murat et al. “Tek Merkez Deneyimi: Feokromasitoma Olgularının Retrospektif Değerlendirilmesi”. Kafkas Journal of Medical Sciences 11/3 (December 2021), 353-359.
JAMA Çalapkulu M, Sencar ME, Östürk Ünsal İ, Sakız D, Özbek M, Çakal E. Tek Merkez Deneyimi: Feokromasitoma Olgularının Retrospektif Değerlendirilmesi. KAFKAS TIP BİL DERG. 2021;11:353–359.
MLA Çalapkulu, Murat et al. “Tek Merkez Deneyimi: Feokromasitoma Olgularının Retrospektif Değerlendirilmesi”. Kafkas Journal of Medical Sciences, vol. 11, no. 3, 2021, pp. 353-9.
Vancouver Çalapkulu M, Sencar ME, Östürk Ünsal İ, Sakız D, Özbek M, Çakal E. Tek Merkez Deneyimi: Feokromasitoma Olgularının Retrospektif Değerlendirilmesi. KAFKAS TIP BİL DERG. 2021;11(3):353-9.
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