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Nadir Görülen Adrenal Neoplazmlar: Tek Merkez Deneyimimiz

Yıl 2025, Cilt: 12 Sayı: 1, 3 - 9, 26.03.2025
https://doi.org/10.34087/cbusbed.1290087

Öz

Öz
Amaç: Adrenal bezler böbrek üzerinde yerleşmiş üçgen şeklinde organlardır. Görüntüleme teknolojilerindeki gelişmeler sayesinde nadir rastlanılan adrenal kitle sayıları artmaya başlamıştır. Çalışmamızın amacı literatürde sınırlı sayıda verisi olan adrenal bezin nadir rastlanılan tümörlerindeki klinik verilerimizi ve tedavi sonuçlarımızı karşılaştırmalı tartışarak literatüre katkı sağlamaktı.
Materyal ve Metod: Ocak 2011 - Ocak 2022 arasında adrenal kitle nedeniyle ameliyat edilen hastaların dosyaları geriye dönük olarak incelendi. 18 yaş üstü nadir görülen adrenal neoplazmı olan hastalar çalışmaya dahil edildi. 18 yaş altı hastalar, sık rastlanılan adrenal neoplazisi olan hastalar ve çoklu veri eksikliği olan hastalar çalışma dışında bırakıldı. Hastaların demografik verileri, hormonal durumları, radyolojik bulguları, histopatolojik tanıları ve takip sonuçları kaydedildi.
Bulgular: Toplam 175 hastaya adrenelektomi yapıldı. Bu hastalardan 36 (%20.5) tanesinin histopatolojik tanısı nadir görülen adrenal neoplazmdı. Hastaların 19’u (%52.7) erkek, 17’si (%47.2) kadındı. Yaş ortalaması 49,9’du (19-77). Histopatolojik inceleme neticesinde hastaların 14’ü (% 8) kist, 9’u (%5.1) malign epitelyal tümör metastazı, 3’ü (%1.7) hemanjiom, 2’si (%5.5) adrenal collision tümör, 1’i (%0.5) miyelolipom, 1’i (%0.5) ganglionöroma, 1’i (%0.5) lipom, 1’i (%0.5) adrenokortikal kanser, 1’i (%0.5) leiomyosarkom, 1’i (%0.5) kompozit tümör, 1’i (%0.5) schwannom ve 1’i (%0.5) nonhodgkin lenfomaydı. Mortalite sayımız 5(%13.8)’ti.
Sonuç: Nadir görülen şüpheli adrenal kitlelerde ve adrenale tek metastazı olan malign hastalıklarda boyut gözetmeksizin yapılacak cerrahi adrenelektomi sağ kalıma olumlu katkı sağlar.

Destekleyen Kurum

Başkent Üniversitesi

Proje Numarası

KA23/92

Teşekkür

Başkent Üniversitesine desteklerinden dolayı teşekkür ederim.

Kaynakça

  • 1. NIH state-of-the-science statement on management of the clinically inapparent adrenal mass ("incidentaloma"). NIH Consensus and State-of-the-Science Statements. 2002;19(2):1-25.
  • 2. Ebbehoj A, Li D, Kaur RJ, et al. Epidemiology of adrenal tumours in Olmsted County, Minnesota, USA: a population-based cohort study. Lancet Diabetes Endocrinology. 20;8(11):894-902.
  • 3. Herrera MF, Grant CS, van Heerden JA, Sheedy PF, Ilstrup DM. Incidentally discovered adrenal tumors: an institutional perspective. Surgery. 1991;110(6):1014-21.
  • 4. Bovio S, Cataldi A, Reimondo G, et al. Prevalence of adrenal incidentaloma in a contemporary computerized tomography series. Journal of Endocrinological Investigation. 2006;29(4):298-302.
  • 5. Jing Y, Hu J, Luo R, et al. Prevalence and Characteristics of Adrenal Tumors in an Unselected Screening Population : A Cross-Sectional Study. Annals of Internal Medicine. 2022; 175:1383.
  • 6. Reimondo G, Castellano E, Grosso M, et al. Adrenal Incidentalomas are Tied to Increased Risk of Diabetes: Findings from a Prospective Study. The Journal of Clinical Endocrinology & Metabolism. 2020;105(4):dgz284.
  • 7. Bourdeau I, El Ghorayeb N, Gagnon N, et al. Lacroix A. Management of Endocrine Disease: Differential diagnosis, investigation and therapy of bilateral adrenal incidentalomas. European Journal of Endocrinology. 2018;179(2):R57-R67.
  • 8. Barzon L, Sonino N, Fallo F, et al. Prevalence and natural history of adrenal incidentalomas. European Journal of Endocrinology. 2003;149(4):273-85.
  • 9. Yilmaz N, Tazegul G, Sari R, et al. Effectıveness of unılateral adrenalectomy ın bılateral adrenal ıncıdentaloma patıents wıth subclınıcal hypercortısolemıa. Acta Endocrinologica (Bucharest). 2021 Oct-Dec;17(4):479-85.
  • 10. Mantero F, Terzolo M, Arnaldi G, et al. A survey on adrenal incidentaloma in Italy. Study Group on Adrenal Tumors of the Italian Society of Endocrinology. The Journal of Clinical Endocrinology & Metabolism. 2000;85(2):637-44.
  • 11. Yoon YC, Sunghwan S, Ji YJ, et al. Clinical characteristics and follow-up of Korean patients with adrenal incidentalomas. The Korean Journal of Internal Medicine. 2013;28(5):557-64. 12. Kloos RT, Gross MD, Francis IR, et al. Incidentally discovered adrenal masses. Endocrine Reviews .1995;16(4):460-84. 13. Grumbach MM, Biller BM, Braunstein GD, et al. Management of the clinically inapparent adrenal mass ("incidentaloma"). Annals of Internal Medicine. 2003;138(5):424-29.
  • 14. Bittner JG 4th, Brunt LM. Evaluation and management of adrenal incidentaloma. Journal of Surgical Oncology. 2012;106(5):557-64.
  • 15. Young WF Jr. Management approaches to adrenal incidentalomas. A view from Rochester, Minnesota. Endocrinology and Metabolism Clinics of North America. 2000;29(1):159-85.
  • 16. Mantero F, Albiger N. A comprehensive approach to adrenal incidentalomas. Arq Bras Endocrinol Metabol. 2004;48(5):583-91.
  • 17. Kuyrukçuoğlu A, Erdoğan N. Pseuodocyst of adrenal. Kartal Eğitim Araştırma Klinikleri II (1-4);991:239-41.
  • 18. Erickson LA, M.D, Ricardo V, Lloyd MD, et al. Cystic Adrenal Neoplasms. Cancer. 2004;101(7):1537-44.
  • 19. Foster DG: Adrenal cysts. Review of literature and report of a case. Archives of Surgery. 1966; 92:131.
  • 20. Lam KY, Lo CY. Metastatic tumours of the adrenal glands: a 30-year experience in a teaching hospital. Clinical Endocrinology (Oxford). 2002;56(1):95-101.
  • 21. McNicholas MM, Lee MJ, Mayo-Smith WW, et al. An imaging algorithm for the differential diagnosis of adrenal adenomas and metastases. American Journal of Roentgenology. 1995;165(6):1453-59.
  • 22. Cingam SR, Mukkamalla SKR, Karanchi H. Adrenal Metastasis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; September 18, 2021.
  • 2. 23.Bhargava P, Sangster G, Haque K, et al. A Multimodality Review of Adrenal Tumors. Current Problems in Diagnostic Radiology . 2019;48(6):605-15.
  • 23. Edwards JP, Stuart HC, Urbanski SJ, et al. A rare cavernous hemangioma of the adrenal gland. International Journal of Surgery Case Reports. 2014;5(2):52-5.
  • 24. Nabi J, Rafiq D, Authoy FN, et al. Incidental detection of adrenal myelolipoma: a case report and review of literature. Case Reports in Urology . 2013;2013:789481.
  • 25. Jeon HJ, Lee SY. A case of adrenal myelolıpoma a patıent wıth breast cancer. Acta Endocrinologica (Bucharest). 2017;13(1):90-5.
  • 26. Sung CT, Shetty A, Menias CO, et al. Collision and composite tumors; radiologic and pathologic correlation. Abdominal Radiology .2017;42(12):2909-26.
  • 27. Michalinos A, Constantinidou A, Kontos M. Gastric collision tumors: an insight into their origin and clinical significance. Gastroenterology Research and Practice | Hindawi. 2015;314158.
  • 28. Enzinger FM, Weiss SW. Soft tissue tumors. Mosby. St.Louis. 1995;929-64.
  • 29. Tataroğlu C, Kaçar Döger F, Çetin Z, et al. Lenf nodu metastazı yapan bir adrenal gagnglionörom: Olgu sunumu. ADÜ Tıp Fakültesi Dergisi 2009; 10(3):47-9.
  • 30. Moriwaki Y, Miyake M, Yamamoıo T, et al. Retroperiıoneal ganglioneuroma. A case report and review of the Japanese literature. Internal Medicine. 1992; 31: 82-5.
  • 31. De Miguel Sánchez C, Ruiz L, González JL, et al. Acute adrenal insufficiency secondary to bilateral adrenal B-cell lymphoma:a case report and review of the literature. Ecancermedicalscience. 2016;10:634.
  • 32. Rizzo C, Camilleri DJ, Betts A, et al. Primary Bilateral Non-Hodgkin’s Lymphoma of the Adrenal Gland Presenting as Incidental Adrenal Masses. Case Report Medicine. 2015;2015:620381.
  • 33. Xiao XR, Ye LY, Shi LX, et al. Diagnosis and treatment of adrenal tumours: a review of 35 years' experience. Brıtısh Journal Of Urology. 1998;82(2):199-205.
  • 34. Luton JP, Cerdas S, Billaud L, et al. Clinical features of adrenocortical carcinoma, prognostic factors, and the effect of mitotane therapy. The New England Journal of Medicine. 1990;322(17):1195-201.
  • 35. Zhou Y, Tang Y, Tang J, et al. Primary adrenal leiomyosarcoma: a case report and review of literature. International Journal of Clinical and Experimental Pathology. 2015 Apr 1;8(4):4258-63.
  • 36. Wagnerova H, Lazurova I, Felsoci M. Adrenal metastases. Bratislava Medical Journal 2013;114(4):237-40.

Rare Adrenal Neoplasms: A Single Center Experience

Yıl 2025, Cilt: 12 Sayı: 1, 3 - 9, 26.03.2025
https://doi.org/10.34087/cbusbed.1290087

Öz

Abstract
Aim: The adrenal glands are triangular organs located above the kidney. Thanks to the developments in imaging technologies, the number of rare adrenal masses has started to increase. The aim of our study was to contribute to the literature by comparatively discussing our clinical data and treatment results in rare tumors of the adrenal gland, which have limited data in the literature.
Materials and Methods: The files of patients who were operated for adrenal mass between January 2011 and January 2022 were retrospectively reviewed, and patients over the age of 18 with rare adrenal neoplasm were included in the study. Patients under 18 years of age, patients with common adrenal neoplasia, and patients with multiple missing data were excluded from the study. Demographic data, hormonal status, radiological findings, histopathological diagnoses and follow-up results of the patients were recorded.
Results: A total of 175 patients underwent adrenalectomy. The histopathological diagnosis of 36 (20.5%) of these patients was a rare adrenal neoplasm. Of the patients, 19 (52.7%) were male and 17 (47.2%) were female. The mean age was 49.9 (19-77). As a result of histopathological examination, 14 (8%) of the patients were cysts, 9 (5.1%) malignant epithelial tumor metastases, 3 (1.7%) hemangiomas, 2 (5.5%) adrenal collision tumors , 1 (0.5%) myelolipoma, 1 (0.5%) ganglioneuroma, 1 (0.5%) lipoma, 1 (0.5%) adrenocortical cancer, 1 ( 0.5% were diagnosed with leiomyosarcoma, 1 (0.5%) composite tumor, 1 (0.5%) schwannoma, and 1 (0.5%) nonhodgkin lymphoma. Our mortality rate was 5 (13.8%).
Conclusion: Surgical adrenalectomy, regardless of size, contributes positively to survival in rare suspicious adrenal masses and malignant diseases with single metastasis to the adrenal gland.

Proje Numarası

KA23/92

Kaynakça

  • 1. NIH state-of-the-science statement on management of the clinically inapparent adrenal mass ("incidentaloma"). NIH Consensus and State-of-the-Science Statements. 2002;19(2):1-25.
  • 2. Ebbehoj A, Li D, Kaur RJ, et al. Epidemiology of adrenal tumours in Olmsted County, Minnesota, USA: a population-based cohort study. Lancet Diabetes Endocrinology. 20;8(11):894-902.
  • 3. Herrera MF, Grant CS, van Heerden JA, Sheedy PF, Ilstrup DM. Incidentally discovered adrenal tumors: an institutional perspective. Surgery. 1991;110(6):1014-21.
  • 4. Bovio S, Cataldi A, Reimondo G, et al. Prevalence of adrenal incidentaloma in a contemporary computerized tomography series. Journal of Endocrinological Investigation. 2006;29(4):298-302.
  • 5. Jing Y, Hu J, Luo R, et al. Prevalence and Characteristics of Adrenal Tumors in an Unselected Screening Population : A Cross-Sectional Study. Annals of Internal Medicine. 2022; 175:1383.
  • 6. Reimondo G, Castellano E, Grosso M, et al. Adrenal Incidentalomas are Tied to Increased Risk of Diabetes: Findings from a Prospective Study. The Journal of Clinical Endocrinology & Metabolism. 2020;105(4):dgz284.
  • 7. Bourdeau I, El Ghorayeb N, Gagnon N, et al. Lacroix A. Management of Endocrine Disease: Differential diagnosis, investigation and therapy of bilateral adrenal incidentalomas. European Journal of Endocrinology. 2018;179(2):R57-R67.
  • 8. Barzon L, Sonino N, Fallo F, et al. Prevalence and natural history of adrenal incidentalomas. European Journal of Endocrinology. 2003;149(4):273-85.
  • 9. Yilmaz N, Tazegul G, Sari R, et al. Effectıveness of unılateral adrenalectomy ın bılateral adrenal ıncıdentaloma patıents wıth subclınıcal hypercortısolemıa. Acta Endocrinologica (Bucharest). 2021 Oct-Dec;17(4):479-85.
  • 10. Mantero F, Terzolo M, Arnaldi G, et al. A survey on adrenal incidentaloma in Italy. Study Group on Adrenal Tumors of the Italian Society of Endocrinology. The Journal of Clinical Endocrinology & Metabolism. 2000;85(2):637-44.
  • 11. Yoon YC, Sunghwan S, Ji YJ, et al. Clinical characteristics and follow-up of Korean patients with adrenal incidentalomas. The Korean Journal of Internal Medicine. 2013;28(5):557-64. 12. Kloos RT, Gross MD, Francis IR, et al. Incidentally discovered adrenal masses. Endocrine Reviews .1995;16(4):460-84. 13. Grumbach MM, Biller BM, Braunstein GD, et al. Management of the clinically inapparent adrenal mass ("incidentaloma"). Annals of Internal Medicine. 2003;138(5):424-29.
  • 14. Bittner JG 4th, Brunt LM. Evaluation and management of adrenal incidentaloma. Journal of Surgical Oncology. 2012;106(5):557-64.
  • 15. Young WF Jr. Management approaches to adrenal incidentalomas. A view from Rochester, Minnesota. Endocrinology and Metabolism Clinics of North America. 2000;29(1):159-85.
  • 16. Mantero F, Albiger N. A comprehensive approach to adrenal incidentalomas. Arq Bras Endocrinol Metabol. 2004;48(5):583-91.
  • 17. Kuyrukçuoğlu A, Erdoğan N. Pseuodocyst of adrenal. Kartal Eğitim Araştırma Klinikleri II (1-4);991:239-41.
  • 18. Erickson LA, M.D, Ricardo V, Lloyd MD, et al. Cystic Adrenal Neoplasms. Cancer. 2004;101(7):1537-44.
  • 19. Foster DG: Adrenal cysts. Review of literature and report of a case. Archives of Surgery. 1966; 92:131.
  • 20. Lam KY, Lo CY. Metastatic tumours of the adrenal glands: a 30-year experience in a teaching hospital. Clinical Endocrinology (Oxford). 2002;56(1):95-101.
  • 21. McNicholas MM, Lee MJ, Mayo-Smith WW, et al. An imaging algorithm for the differential diagnosis of adrenal adenomas and metastases. American Journal of Roentgenology. 1995;165(6):1453-59.
  • 22. Cingam SR, Mukkamalla SKR, Karanchi H. Adrenal Metastasis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; September 18, 2021.
  • 2. 23.Bhargava P, Sangster G, Haque K, et al. A Multimodality Review of Adrenal Tumors. Current Problems in Diagnostic Radiology . 2019;48(6):605-15.
  • 23. Edwards JP, Stuart HC, Urbanski SJ, et al. A rare cavernous hemangioma of the adrenal gland. International Journal of Surgery Case Reports. 2014;5(2):52-5.
  • 24. Nabi J, Rafiq D, Authoy FN, et al. Incidental detection of adrenal myelolipoma: a case report and review of literature. Case Reports in Urology . 2013;2013:789481.
  • 25. Jeon HJ, Lee SY. A case of adrenal myelolıpoma a patıent wıth breast cancer. Acta Endocrinologica (Bucharest). 2017;13(1):90-5.
  • 26. Sung CT, Shetty A, Menias CO, et al. Collision and composite tumors; radiologic and pathologic correlation. Abdominal Radiology .2017;42(12):2909-26.
  • 27. Michalinos A, Constantinidou A, Kontos M. Gastric collision tumors: an insight into their origin and clinical significance. Gastroenterology Research and Practice | Hindawi. 2015;314158.
  • 28. Enzinger FM, Weiss SW. Soft tissue tumors. Mosby. St.Louis. 1995;929-64.
  • 29. Tataroğlu C, Kaçar Döger F, Çetin Z, et al. Lenf nodu metastazı yapan bir adrenal gagnglionörom: Olgu sunumu. ADÜ Tıp Fakültesi Dergisi 2009; 10(3):47-9.
  • 30. Moriwaki Y, Miyake M, Yamamoıo T, et al. Retroperiıoneal ganglioneuroma. A case report and review of the Japanese literature. Internal Medicine. 1992; 31: 82-5.
  • 31. De Miguel Sánchez C, Ruiz L, González JL, et al. Acute adrenal insufficiency secondary to bilateral adrenal B-cell lymphoma:a case report and review of the literature. Ecancermedicalscience. 2016;10:634.
  • 32. Rizzo C, Camilleri DJ, Betts A, et al. Primary Bilateral Non-Hodgkin’s Lymphoma of the Adrenal Gland Presenting as Incidental Adrenal Masses. Case Report Medicine. 2015;2015:620381.
  • 33. Xiao XR, Ye LY, Shi LX, et al. Diagnosis and treatment of adrenal tumours: a review of 35 years' experience. Brıtısh Journal Of Urology. 1998;82(2):199-205.
  • 34. Luton JP, Cerdas S, Billaud L, et al. Clinical features of adrenocortical carcinoma, prognostic factors, and the effect of mitotane therapy. The New England Journal of Medicine. 1990;322(17):1195-201.
  • 35. Zhou Y, Tang Y, Tang J, et al. Primary adrenal leiomyosarcoma: a case report and review of literature. International Journal of Clinical and Experimental Pathology. 2015 Apr 1;8(4):4258-63.
  • 36. Wagnerova H, Lazurova I, Felsoci M. Adrenal metastases. Bratislava Medical Journal 2013;114(4):237-40.
Toplam 35 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makalesi
Yazarlar

Serkan Erkan 0000-0002-4981-5492

Hakan Yabanoğlu 0000-0002-1161-3369

Tevfik Avcı 0000-0001-5225-959X

Fatma Özarslan 0000-0002-0634-300X

Gülay Şimsek Bağır 0000-0001-5747-407X

Emrah Koçer 0000-0002-5943-9283

Proje Numarası KA23/92
Erken Görünüm Tarihi 26 Mart 2025
Yayımlanma Tarihi 26 Mart 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 12 Sayı: 1

Kaynak Göster

APA Erkan, S., Yabanoğlu, H., Avcı, T., Özarslan, F., vd. (2025). Nadir Görülen Adrenal Neoplazmlar: Tek Merkez Deneyimimiz. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 12(1), 3-9. https://doi.org/10.34087/cbusbed.1290087
AMA Erkan S, Yabanoğlu H, Avcı T, Özarslan F, Şimsek Bağır G, Koçer E. Nadir Görülen Adrenal Neoplazmlar: Tek Merkez Deneyimimiz. CBU-SBED. Mart 2025;12(1):3-9. doi:10.34087/cbusbed.1290087
Chicago Erkan, Serkan, Hakan Yabanoğlu, Tevfik Avcı, Fatma Özarslan, Gülay Şimsek Bağır, ve Emrah Koçer. “Nadir Görülen Adrenal Neoplazmlar: Tek Merkez Deneyimimiz”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 12, sy. 1 (Mart 2025): 3-9. https://doi.org/10.34087/cbusbed.1290087.
EndNote Erkan S, Yabanoğlu H, Avcı T, Özarslan F, Şimsek Bağır G, Koçer E (01 Mart 2025) Nadir Görülen Adrenal Neoplazmlar: Tek Merkez Deneyimimiz. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 12 1 3–9.
IEEE S. Erkan, H. Yabanoğlu, T. Avcı, F. Özarslan, G. Şimsek Bağır, ve E. Koçer, “Nadir Görülen Adrenal Neoplazmlar: Tek Merkez Deneyimimiz”, CBU-SBED, c. 12, sy. 1, ss. 3–9, 2025, doi: 10.34087/cbusbed.1290087.
ISNAD Erkan, Serkan vd. “Nadir Görülen Adrenal Neoplazmlar: Tek Merkez Deneyimimiz”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 12/1 (Mart 2025), 3-9. https://doi.org/10.34087/cbusbed.1290087.
JAMA Erkan S, Yabanoğlu H, Avcı T, Özarslan F, Şimsek Bağır G, Koçer E. Nadir Görülen Adrenal Neoplazmlar: Tek Merkez Deneyimimiz. CBU-SBED. 2025;12:3–9.
MLA Erkan, Serkan vd. “Nadir Görülen Adrenal Neoplazmlar: Tek Merkez Deneyimimiz”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, c. 12, sy. 1, 2025, ss. 3-9, doi:10.34087/cbusbed.1290087.
Vancouver Erkan S, Yabanoğlu H, Avcı T, Özarslan F, Şimsek Bağır G, Koçer E. Nadir Görülen Adrenal Neoplazmlar: Tek Merkez Deneyimimiz. CBU-SBED. 2025;12(1):3-9.