Adrenal insidentalomalarda cerrahi yaklaşım: On üç olgu sunumu ve literatür derlemesi
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Dosyalar
Tarih
2016
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Adrenal insidentalomalar rutin görüntüleme tekniklerinde yaklaşık %4-7 oranında tespit edilirler. Çoğunlukla benign olmakla birlikte dikkatli klinik ve laboratuvar incelemeleri sonrasında karsinom veya fonksiyonel adenomlar belirlenebilir.Gereç ve Yöntemler: Ocak 2010-Haziran 2014 tarihleri arasında adrenal kitle tespit edilerek cerrahi tedavi uygulanan 13 hastanın bulguları retrospektif olarak incelendi.Bulgular: Olgulardan 7'si (%54) erkek, 6'sı (%46) kadın, ortalama yaş 38,2 idi. Klinik tanılarda 5 hastada (%38,4) feokromasitoma, 5 hastada (%38,4) nonfonksiyone adenom, 1 hastada (%7,6) metastatik lezyon, 1 hastada (%7,6) Cushing sendromu, 1 hastada (%7,6) sürrenal karsinom tespit edilmiştir. Cerrahi tedavi uygulanan hastaların 8'ine laparotomi ile, 52'sine de laparoskopik adrenalektomi uygulanmıştır.Sonuç: Adrenal insidentaloma saptanan olgular asemptomatik olsa dahi hormonal yönden detaylı olarak incelenmeli, non-fonksiyone kitlelere ise malignite kuşkulu lezyonlar olarak bakılmalıdır. Kitle boyutu 6 cm'den küçük ve komşu organ infiltrasyonu bulunmayan hastalarda laparoskopik adrenalektomi altın standart haline gelmektedir.
Objective: The rate of adrenal incidentalomas detected in routine diagnostic imaging techniques is approximately 4-7%. Although the lesions are generally benign, carcinoma and functional adenomas can be diagnosed with careful clinic and laboratory evaluation.Material and Methods: Data of 13 patients who underwent surgery for an adrenal mass between January 2010-June 2014 were analyzed retrospectively.Results: Seven (54%) patients were male, 6 (46%) were female, and the mean age was 38.2. The clinical diagnosis was pheochromacytoma in 5 patients (38.4%), non-functional adenoma in 5 (38.4), and metastatic lesion, Cushing syndrome, and adrenal carcinoma each in one patient (7.6%). Conventional open adrenalectomy was performed in 8 patients, while 5 patients underwent laparoscopic adrenalectomy.Conclusion: Adrenal incidentalomas should be carefully evaluated for hormonal activity even if asymptomatic, and non-functional lesions should be considered as suspicious-for-malignancy. Laparoscopic adrenalectomy has become the gold standard for patients with a mass less than 6 cm, and without infiltration to adjacent organs.
Objective: The rate of adrenal incidentalomas detected in routine diagnostic imaging techniques is approximately 4-7%. Although the lesions are generally benign, carcinoma and functional adenomas can be diagnosed with careful clinic and laboratory evaluation.Material and Methods: Data of 13 patients who underwent surgery for an adrenal mass between January 2010-June 2014 were analyzed retrospectively.Results: Seven (54%) patients were male, 6 (46%) were female, and the mean age was 38.2. The clinical diagnosis was pheochromacytoma in 5 patients (38.4%), non-functional adenoma in 5 (38.4), and metastatic lesion, Cushing syndrome, and adrenal carcinoma each in one patient (7.6%). Conventional open adrenalectomy was performed in 8 patients, while 5 patients underwent laparoscopic adrenalectomy.Conclusion: Adrenal incidentalomas should be carefully evaluated for hormonal activity even if asymptomatic, and non-functional lesions should be considered as suspicious-for-malignancy. Laparoscopic adrenalectomy has become the gold standard for patients with a mass less than 6 cm, and without infiltration to adjacent organs.
Açıklama
Anahtar Kelimeler
Tıbbi Laboratuar Teknolojisi, Tıbbi Araştırmalar Deneysel, Onkoloji, Radyoloji, Nükleer Tıp, Tıbbi Görüntüleme, Cerrahi, Üroloji ve Nefroloji
Kaynak
Ulusal Cerrahi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
32
Sayı
2
