Adrenal insidentaloma’lı hastalarda klinik, biyokimyasal ve radyolojik retrospektif analiz

Year 2022, Volume: 15 Issue: 2, 382 - 392, 31.08.2022

Zeynep Ebru Eser Ramazan Gen Kadir Eser Kerem Sezer Esen Akbay

https://doi.org/10.26559/mersinsbd.1109724

Abstract

Giriş: Bu çalışmada, adrenal insidentaloma nedeniyle takip edilen hastaların epidemiyolojik, demografik, klinik özellikleri, tedavi yaklaşımları ve yaşam sürelerinin değerlendirilmesi amaçlanmıştır. Yöntem: 2010–2014 yılları arasında Mersin Üniversitesi Araştırma ve Uygulama Hastanesi Endokrinoloji Bölümünde adrenal insidentaloma nedeniyle tedavi ve takipleri yapılan 46 hastanın verileri retrospektif olarak incelendi. Bulgular: Çalışmaya alınan olguların 13’ü erkek, 33’ü kadın ve yaş ortalaması 54.09±10.7 idi. En sık başvuru nedeni %34.78 hastada karın ağrısı, en sık tanı konulan radyolojik yöntem % 60.87 dinamik sürrenal BT, en sık yerleşim yeri sol surrenal bezdi. Kitle çapı ortalama 26.8±16.5 mm arasında idi. Hipertansiyon sıklığı %50, obezite sıklığı %47.8, tip 2 diyabet sıklığı %21.7, osteoporoz sıklığı ise %42.8 ve metabolik sendrom sıklığı %41.3 olarak saptandı. Hormonal değerlendirme sonuçlarına göre %82.61’inde fonksiyonsuz adrenal adenom (FAA), %15.21’inde subklinik Cushing sendromu (SCS), %2.1’inde aldesteronoma görüldü. Adrenalektomiye giden 8 olguda myelolipom, feokromasitoma ve adrenokortikal adenom tanısı konuldu. Bir hasta karaciğer yetmezliğinden exitus oldu. Hastaların takiplerinde hormonal aktivasyon ve lezyon boyutunda büyüme saptanmadı. Sonuç: AI’ların çok farklı patolojik ve radyolojik görünümler ile karşımıza çıkmasından dolayı demografik, etiyolojik, klinik, laboratuar ve radyolojik verilerin bir bütün olarak değerlendirilmesi tedavi ve takibinde önemlidir.

Keywords

Adrenal insidentaloma, subklinik cushing sendromu, fonksiyonsuz adrenal adenom, teşhis, tedavi

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Clinical, biochemical and radiological retrospective analysis in patients with adrenal incidentaloma

Abstract

Introduction: The aim of this study was to evaluate the epidemiological, demographic, clinical features, treatment approaches and survival of patients followed up for adrenal incidentaloma. Methods: The data of 46 patients who underwent treatment and follow-up for adrenal incidentaloma in Mersin University Health Research and Practice Hospital, Endocrinology Department between 2010 and 2014 were retrospectively analyzed. Results: The study group consisted of 13 male and 33 female patients. The mean age was 54.09 ± 10.7 years. The most common reason for admission was abdominal pain in 34.78% of patients, the most commonly diagnosed radiological method was 60.87% dynamic surrenal CT, and the most common localization was right surrenal gland. The mean diameter of the mass was 26.8±16.5 mm. The prevalence of hypertension was 50%, obesity was 47.8%, type 2 diabetes was 21.7%, osteoporosis was 42.8% and metabolic syndrome was 41.3%. According to the results of hormonal evaluation, 82.61% of the patients had dysfunctional adrenal adenoma (FAA), 15.21% of them had subclinical Cushing syndrome (SCS) and 2.1% of them had aldesteronoma. Myelolipoma, benign pheochromocytoma and adrenocortical adenoma were diagnosed in 8 patients who underwent adrenalectomy. One patient died due to liver failure. No hormonal activation and lesion size growth was detected in the follow-up of the patients. Conclusion: Because of the different pathological and radiological features of AI, it is important to evaluate demographic, etiological, clinical, laboratory and radiological data as a whole in treatment and follow-up.

Keywords

Adrenal incidentaloma, subclinical Cushing syndrome, dysfunctional adrenal adenoma, diagnosis, treatment

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