Adrenal İnsidentalomalarda Fonksiyonellik ve Büyüme Oranlarının Değerlendirilmesi: Tek Merkez Deneyimi

Öz

Amaç: Bu çalışmada merkezimizde karşılaştığımız insidentaloma vakalarının radyolojik, histopatolojik özellikleri ve hormonal aktiviteleri yönünden gözlemsel verilerini aktarmayı, takipleri esnasında büyüme oranlarını retrospektif olarak incelemeyi amaçladık. Gereç ve Yöntem: Dahil edilme kriterlerine uyan 137 insidentaloma vakaları retrospektif olarak incelendi. Tüm olguların medikal kayıtlarından yaş, cinsiyet bilgileri, hormonal tetkik ve görüntüleme sonuçları, kitlelerin fonksiyonellik durumları, histopatolojik bulguları ve takipleri boyunca adrenal kitle çapındaki değişim bilgileri kaydedilerek istatistiksel yöntemlerle analiz edildi. Bulgular: Hastaların 97’si (%71) kadın, 40’ı (%29) erkek idi. 99 (%72.3) hastaya nonfonksiyonel adenom (NFA), 21 (%15) hastaya subklinik Cushing sendromu (SCS), 9 (%6) hastaya feokromasitoma, 6 (%4) hastaya hiperaldosteronizm, 2 (%1) hastaya konjenital adrenal hiperplazi (KAH) tanısı koyuldu. Fonksiyonel kitleye sahip olan hastalar anlamlı olarak daha genç saptandı (p:0,04). 6 (%4) hastada malignite saptandı. Hastaların ortalama takip süresi 20.2±19.86 ay idi. Takipler sırasında 24 hastada (%17) kitle boyutunda büyüme saptandı. Kitlelerin 6’sında (büyüyen kitlelerin %26, tüm kitlelerin %4 ü) 1 cm üzerinde büyüme görüldü. Erkek hastalardaki kitlelerin büyüme miktarı, kadın hastaların kitlelerdeki büyüme miktarından anlamlı olarak daha yüksekti (p:0.031). Sonuç: Kitle büyüme miktarı ve malignite görülme sıklığı ileri yaş ve erkek cinsiyette daha fazla saptanmıştır. İnsidentalomaların fonksiyonellik ve malign dönüşüm açısından takibinde hastaların yaşı ve cinsiyeti göz önünde bulundurulmalıdır.

Anahtar Kelimeler

• Subklinik Cushing
• Feokromasitoma
• Hiperaldesteronizm
• Adrenokortikal Kanser
• Adrenal
• İnsidentaloma

Evaluation of Functionality and Growth Rates in Adrenal Incidentalomas: Single Center Experience

Öz

Objectives: In this study, we aimed to transfer observational data on incidentaloma cases, which we encountered in our center, in terms of their radiological, histopathologic features and hormonal activities, retrospectively review the growth rates during follow-up. Material and Method: In this retrospective study 137 incidentaloma cases that met the inclusion criteria were analyzed. The medical records of all cases were analyzed statistically by recording age, sex information, hormonal examinations and imaging results, functional status of masses, histopathological findings, and information on adrenal mass diameter change during follow-up. Results: In this study, 97 (71%) patients were female and 40 (29%) were male. 99 patients (72.3%) were diagnosed with nonfunctional adenomas (NFA), 21 patients (15%) with subclinical Cushing syndrome (SCS), 9 patients (6%) with pheochromocytoma, 6 patients (4%) with hyperaldosteronism, and 2 patients (1%) with congenital adrenal hyperplasia (CAH). Patients with functional masses were significantly younger than patients with NFA (p: 0.04). Malignancy was identified in 6 patients (4%). The mean follow-up period of the patients was 20.2 ± 19.86 months. Growth in mass size was detected in 24 patients (17%). In 6 of the masses (26% of the growing masses, 4% of all the masses), growth of over 1 cm was observed. The growth rate of the masses in male patients was significantly higher than the growth rate in female patients (p: 0.031). Conclusion: The incidence of mass growth and malignancy was higher in older age and male sex. Patient’s age and sex should be bear in mind for their duration and frequency of follow-up in terms of functionality and malignant conversion.

Anahtar Kelimeler

• Adrenal
• Incidentaloma,
• Subclinical Cushing
• Pheochromocytoma
• Hyperaldosteronism
• Adrenocortical Cancer

Kaynakça

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