Nonfonksiyonel Hipofiz Adenomlarının Cerrahi Endikasyonları ve Yönetimi

Abstract

Aktif hormon sekresyonu yapmayan hipofiz tümörleri nonfonksiyonel adenom olarak

adlandırılmaktadır. Tüm hipofiz adenomları içerisindeki oranları %30-35’dir. Bunların

ekseriside (%80-90) gonodotropik adenomlar tarafından oluşturulmaktadır. Hastalar

genellikle nörolojik semptomlar ya da hipofizer yetmezlik şeklinde klinik gösterirler.

Nonfonksyonel adenomu bulunan hastaların tedavisindeki amaçlar; nörolojik semptomların

düzeltilmesi, nükse müsaade etmeyecek şekilde mümkünse makroadenom dokusunun

tamamen çıkartılması ve normal hipofiz dokusunun basısı sonucu gelişen hormonal

yetmezliğin yönetimidir.

Keywords

• Hipofiz adenomu,nonfonksiyonel,yönetim,cerrahi

References

1. 1. Dekkers OM, Hammer S, de Keizer RJ, Roelfsema F, Schutte PJ, Smit JW et al. The natural course of non-functioning pituitary macroadenomas.Eur J Endocrinol. 2007 Feb;156(2):217-24. 2. Molitch ME. Nonfunctioning pituitary tumors and pituitary incidenta- lomas.EndocrinolMetabClin North Am. 2008 Mar;37(1):151-71, xi. 3. Nawar RN, AbdelMannan D, Selman WR, Arafah BM.Pituitary tumor apoplexy: a review. J IntensiveCareMed. 2008 Mar;23(2):75-90. 4. Dekkers OM, Pereira AM, Romijn JA. Treatment and follow-up of clinicallynon-functioning pituitary macroadenomas.J Clin Endocrinol Metab. 2008 Oct;93(10) 3717-26. Epub 2008 Aug 5. 5. Ceylan S, Anik I, Koc K, Ciftci E, Cabuk B. Endoscopic approach to cavernous sinus aneurysm.Turk Neurosurg. 2013;23(3):404-6. 6. Inder WJ, Hunt PJ. Glucocorticoid replacement in pituitary surgery: guidelines for perioperative assessment and management. J Clin Endocrinol Metab. 2002 Jun;87(6):2745-50. 7. Ausiello JC, Bruce JN, Freda PUPostoperative assessment of the patient after transsphenoidal pituitary surgery.Pituitary. 2008;11(4):391 8. Adams JR, Blevins LS Jr, Allen GS, Verity DK, Devin JK. Disorders of water me-tabolism following transsphenoidal pituitary surgery: a single institution's experi-ence.Pituitary. 2006;9(2):93-9. 9. Murad MH, Fernández-Balsells MM, Barwise A, Gallegos- Orozco JF, Paul A, Lane MA, et all. Outcomes of surgical treatment for nonfunctioning pituitary adenomas: a systematic review and meta-analysis.ClinEndocrinol (Oxf). 2010 Dec;73(6):777-91. 10. Woollons AC, Hunn MK, Rajapakse YR, Toomath R, Hamilton DA, Conaglen JV, et all. Non-functioning pituitary adenomas: indications for postoperative radiother-apy.Clin Endocrinol (Oxf). 2000 Dec;53(6):713-7. 11. Tsang RW, Brierley JD, Panzarella T, Gospodarowicz MK, Sutcliffe SB, Simpson WJ Radiation therapy for pituitary adenoma: treatment outcome and prognostic fac-tors.Int J RadiatOncolBiolPhys. 1994;30(3):557. 12. McCord MW, Buatti JM, Fennell EM, Mendenhall WM, Marcus RB Jr, Rhoton AL et all. Radiotherapy for pituitary adenoma: long-term outcome and sequelae.Int J RadiatOncolBiolPhys. 1997;39(2):437. 13. van den Bergh AC, van den Berg G, Schoorl MA, Sluiter WJ, van der Vliet AM, Hoving EW et all. Immediate postoperative radiotherapy in residual nonfunctioning pituitary adenoma: beneficial effect on local control without additional negative im-pact on pituitary function and life expectancy.Int J RadiatOncolBiolPhys. 2007;67(3):863. 14. Dekkers OM, Pereira AM, Romijn JA. Treatment and follow-up of clinically non-functioning pituitary macroadenomas. J ClinEndocrinolMetab. 2008 Oct;93(10):3717-26. Epub 2008 Aug 5. 15. Karavitaki N, Thanabalasingham G, Shore HC, Trifanescu R, Ansorge O, Meston N, et all. Do the limits of serum prolactin in disconnection hyperprolactinaemia need re-definition? A study of 226 patients with histologically verified non-functioning pituitary macroadenoma.Clin Endocrinol (Oxf). 2006 Oct;65(4):524-9.