Subklinik Cushing sendromlu olgu bağlamında adrenal insidentalomalara genel yaklaşım

Year 2016, Volume: 41 Issue: 2, 363 - 369, 30.06.2016

Mehtap Evran , Murat Sert Tamer Tetiker

Abstract

Adrenal insidentalomalar başka nedenlerle yapılan görüntüleme testleri sırasında saptanan lezyonlardır. Günümüzde abdominal görüntüleme tekniklerinin yaygın olarak kullanılmaya başlanması ile birlikte adrenal insidentaloma tanısının sıklığı artmıştır. Adrenal insidentalomaların değerlendirilmesinde ilk basamak lezyonun hormonal olarak aktif olup olmadığı ya da kitlenin benign veya malign olup olmadığıdır. Bu değerlendirme tedavi planlanması ve hastanın takibi için önemlidir.

Keywords

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General approach to adrenal incidentalomas with regards to a case with subclinical Cushing syndrome

Abstract

Adrenal incidentalomas are masses that are discovered by imaging tests performed for other reasons. Today, in line with the increased use of imaging methods as computerized tomography and magnetic resonance imaging, the prevalence of diagnosis of adrenal incidentaloma has increased. The first stage that must be assessed after diagnosing adrenal incidentaloma is the examination of the mass in terms of hormonal status and malignancy. This evaluation is important for follow-up of the patients and for treatment planning.

Keywords

Adrenal incidentalomas, treatment, prognosis Anahtar kelimeler: Adrenal kitleler, tedavi, prognoz

References

• Barzon L, Sonino N, Fallo F, Palu G, Boscaro M. Prevalence and natural history of adrenal incidentalomas. Eur J Endocrinol. 2003;149:273-85.
• Young WF. Jr. Management approaches to adrenal incidentalomas. a view from Rochester, Minnesota. Endocrinol Metab Clin North Am. 2000;29:159-85.
• Terzolo M, Pia A, Ali A, Osella G, Reimondo G, Bovio S et al. Adrenal incidentaloma: a new cause of the metabolic syndrome? J Clin Endocrinol Metab. 2002;87:998-1003.
• Erbil Y, Barbaros U. Management of the adrenal incidentalomas. Turkiye Klinikleri J Gen Surg-Special Topics. 2008;1:10-6.
• Mantero F, Terzolo M, Arnaldi G, Osella G, Masini AM, Ali A et al. A survey on adrenal incidentaloma in Italy. Study Group on Adrenal Tumors of the Italian Society of Endocrinology. Clin Endocrinol Metab. 2000;85:637-44.
• Abecassis M, McLoughlin MJ, Langer B, Kudlow JE. Serendipitous significance, and management. Am J Surg. 1985;149:783-8. masses: prevalence,
• Herrera MF, Grant CS, van Heerden JA, Sheedy PF, Ilstrup DM. Incidentally discovered adrenal tumors:an institutional perspective. Surgery. 1991;110:1014-21.
• Korobkin M, Lomberdi TJ, Alisen AM, Francis IR, Quint LE, Dunnick NR et al. Characterization of adrenal masses with chemical shift and godolinum enhanced MR imaging. Radiology. 1995;197:411-8.
• Tutuncu NB, Gedik O. Adrenal incidentaloma: report of 33 cases. J Surg Oncol. 1999;70:247–50.
• Young WF, Jr. Clinical practice. The incidentally discovered adrenal mass. N Engl J Med. 2007;356:601-10.
• Mantero F, Terzolo M, Arnaldi G, Osella G, Masini AM, Alì A et al. A survey on adrenal incidentaloma in Italy. Study Group on Adrenal Tumors of the Italian Society of Endocrinology. J Clin Endocrinol Metab. 2000;85:637-44.
• Cicala MV, Sartorato P, Mantero F. Incidentally discovered masses in hypertensive patients. Best Pract Res Clin Endocrinol Metab. 2006;20:451-66.
• Funder JW, Carey RM, Fardella C, Gomez-Sanchez CE, Mantero F, Stowasser M et al. Case detection, diagnosis, and treatment of patients with primary aldosteronism: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2008;93:3266-81.
• Allolio B. Adrenal incidentaloma. In Adrenal Disorders (Ed AN Margioris):249-61. Totowa, Humana Pres, 2001.
• Zeiger MA, Thompson GB, Duh QY, Hamrahian AH, Angelos P, Elaraj D et al. Association of Clinical Endocrinologists and American Association of Endocrine Surgeons Medical Guidelines for the Management of Adrenal Incidentalomas: executive summary of recommendations. Endocr Pract. 2009;15:450-3.
• Reincke M, Nieke J, Krestin GP, Saeger W, Allolio B, Winkelmann W. Preclinical Cushing's syndrome in adrenal "incidentalomas": comparison with adrenal Cushing's syndrome. J Clin Endocrinol Metab. 1992;75:826-32.
• Adrenal ve Gonadal Hastalıklar Kılavuzu. Türkiye Endokrinoloji ve Metabolizma Derneği Adrenal ve Gonadal Hastalıklar Çalışma Grubu 2011, Ankara.
• Valli N, Catargi B, Ronci N, Vergnot V, Leccia F, Ferriere JM et al. Biochemical screening for subclinical cortisol-secreting adenomas amongst adrenal incidentalomas. Eur J Endocrinol. 2001;144:401-8.
• Barzon L, Fallo F, Sonino N, Boscaro M. Overnight dexamethasone suppression of cortisol is associated with radiocholesterol uptake patterns in adrenal incidentalomas. Eur J Endocrinol. 2001;145:223-4.
• Delibaşı T. Endokrin hastalıkların tanısında hormonal tetkikler ve dinamik testler. Türkiye Klinikleri Endokrinoloji Dergisi Endokrinolojide Tanı Testleri Özel Sayısı. 2010;3:25-39.
• van Berkel A, Lenders JWM, Timmers HJLM. Biochemical diagnosis of phaechromocytoma and paraganglioma. Eur J Endocrinol. 2014;170:109-9.
• Grouzmann E, Drouard-Troalen L, Baudin E, Plouin PF, Muller B, Grand D et al. . Diagnostic accuracy of free and total metanephrines in plasma and fractionated metanephrines in urine of patients with pheochromocytoma. Eur J Endocrinol. 2010;162:951-60.
• Sawka AM, Jaeschke R, Sıngh RJ, Young WF, A comparison pheochromocytoma: measurement of fractionated plasma metanephrines compared to the combination of 24-hour catecholamines. J Clin Endocrinol Metab. 2003;88:553-8. tests for urinary metanephrines and
• Montori VM, Young WF Jr. Use of plasma aldosterone concentration-to-plasma renin activity ratio as a screening test for primary aldosteronism. A systematic review of the literature. Endocrinol Metab Clin North Am. 2002;31:619-32.
• Aubert S, Wacrenier A, Leroy X, Devos P, Carnaille B, Proye C et al. Weiss system revisited a clinicopathologic and immunohistochemical study of 49 adrenocortical tumors. Am J Surg Pathol. 2002;26:1612-9.
• Villar JM, Moreno P, Ortega J, Bollo E, Ramírez CP, Muñoz N et al. Results of adrenal surgery. Data of a Spanish National Survey. Langenbecks Arch Surg 2010;395:837-43.
• Barzon L, Scaroni C, Sonino N, Fallo F, Gregianin M, Macri C et al. Incidentally discovered adrenal tumors: endocrine and scintigraphic correlates. J Clin Endocrinol Metab. 1998;83:55-62.
• 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;14:587–99.
• Boland GW, Blake MA, Hahn PF, Mayo-Smith WW. Incidental adrenal lesions: principles, techniques, and algorithms for imaging characterization Radiology. 2008;249:756–75.
• Chiodini I, Guglielmi G, Battista C, Carnevale V, Torlontano M, Cammisa M et al. Spinal volumetric bone mineral density and vertebral fractures in female patients with adrenal incidentalomas: the effects of subclinical hipercortisolism and gonadal status. J Clin Endocrinol Metab. 2004;89:2237-41.
• Blake MA, Cronin CG, Boland GW. Adrenal imaging. AJR Am J Roentgenol. 2010;194:1450–60.
• Blake MA, Kalra MK, Maher MM, Sahani DV, Sweeney AT, Mueller PR et al. Pheochromocytoma: an imaging chameleon. Radiographics 2004;24:87– 99.
• Nieman LK. Approach to the patient with an adrenal incidentaloma. J Clin Endocrinol Metab. 2010;95:4106–13.
• Nawar R, Aron D. Adrenal incidentalomas- a continuing management dilemma Endocr Relat Cancer. 2005;12:585-98.
• NIH state-of-the-science statement on management of the clinically inapparent adrenal mass ("incidentaloma"). NIH Consens State Sci Statements. 2002;19(2):1-25.
• AACE/AAES Adrenal Incidentaloma Guidelines. Endocr Pract. 2009;15:37.
• Aron D, Terzolo M, Cawood TJ. Adrenal incidentalomas. Best Pract Res Clin Endocrinol Metab. 2012;26:69-82.
• Dunnick NR, Korobkin M, Francis I. Adrenal radiology: distinguishing benign from malignant adrenal masses. AJR Am J Roentgenol. 1996;167:861-7.
• Pantalone KM, Gopan T, Remer EM, Faiman C, Ioachimescu AG, Levin HS et al. Change in adrenal mass size as a predictor of a malignant tumor. Endocr Pract. 2010;16:577-87.