Hipofiz Makroadenomu Olan 25 Hastanın Retrospektif Olarak Değerlendirilmesi
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Dosyalar
Tarih
2004
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi Tıp Fakültesi Dergisi
Erişim Hakkı
Attribution 3.0 United States
info:eu-repo/semantics/openAccess
info:eu-repo/semantics/openAccess
Özet
Bu çalışmanın amacı, 2000-2004 yılları arasında Nöroşirurji ve Endokrinoloji Kliniklerimizde tedavi edilen hipofizer makroadenomlu 25 hastanın (15 kadın, 10 erkek, yaş ortalaması 43.24 ± 15.44 yıl) retrospektif olarak incelenmesidir. Yöntem: Hastalar demografik ve endokrinolojik bulgulara, tümörün çapı, yayılımı ve operasyon şekline göre değerlendirilmiştir. Bulgular: Olguların 12’si klinik olarak non-fonksiyone adenom (CNFT), 6’sı prolaktinoma, 5’i akromegali ve 2’si kranyofarinjiomadır. CNFT’lü vakalarda erkekler (%58.3), akromegali (%80) ve prolaktinomalarda (%66.6) ise kadınlar çoğunluktaydı. Kranyofarinjiomalı iki olgu da kadındı. Baş ağrısı (%52) görme bozuklukları (%36) and hipogonadal semptomlar (%16) başvuru anında belirtilen en sık şikayetlerdi. Hipogonadotropik hipogonadizm ve hipopitüitarizm tedavi öncesi tespit edilen en sık endokrinolojik bozukluklardı. Hastaların 18’i tümör özelliğine göre transsfenoidal (n=10, %40) yada transkranyal yoldan (n=8, %32) opere edildi. Nüks oranı %22.2 bulundu. Operasyonlardan sonra hipopitüitarizmin %28’den %50’ye (n=9), ve kalıcı diabetes insipidusun %4’ten %27.8’e (n=5) yükseldiği görülürken, vizyon bozukluklarının % 48’den %20’ye, oftalmopleji oranının ise %20’den %4’e düştüğü görüldü. Sonuç: Her ne kadar hipofiz adenomlarında yeni tedavi yaklaşımları umut vaat ediyorsa da, makroadenomlar gerek kitle etkileri gerekse operasyona bağlı nedenlerle endokrinolojik ve cerrahi açıdan hala ciddi bir sorun olarak görünmektedir.
The aim of this study is to retrospectively evaluate the 25 patients (15 female, 10 male, mean age 43.24 ± 15.44 years) with pituitary macroadenomas; 12 clinically non-functioning tumors (CNFTs), 6 prolactinomas, 5 acromegalies, and 2 craniopharingiomas attempted to our Neurosurgery and Endocrinology Clinics. Methods: The patients were evaluated demographically and endocrinologically with the nature of the tumor and operation modalities. Results: Male dominancy was defined in CNFTs (58.3%), but in acromegalies (80%), and prolactinomas (66.6%) most of the patients were female. Both of the craniopharingiomas were women as well. Headache was the predominant (52%) complaint for all the cases, visual disturbances (36%) and hypogonadal symptoms (16%) were the others. Hypogonadotropic hypogonadism and hypopituitarism were the most frequent endocrinologic abnormalities at admission. Eighteen of the patients were operated. In 10 (40%) of them transsphenoidal surgery, and in 8 (32%) transcranial surgery was performed. The recurrence rate was 22.2%. Hypopituitarism was increased up to 50% (n=9) from 28%, and sustained diabetes insipidus from 4% to 27.8% (n=5) postoperatively. Conclusion: Despite new treatment modalities in functioning adenomas promise expectations, pituitary macroadenomas seem to sustain as a dilemma especially for the endocrinologic dysfunctions in regards of tumor mass effect or operation sequels.
The aim of this study is to retrospectively evaluate the 25 patients (15 female, 10 male, mean age 43.24 ± 15.44 years) with pituitary macroadenomas; 12 clinically non-functioning tumors (CNFTs), 6 prolactinomas, 5 acromegalies, and 2 craniopharingiomas attempted to our Neurosurgery and Endocrinology Clinics. Methods: The patients were evaluated demographically and endocrinologically with the nature of the tumor and operation modalities. Results: Male dominancy was defined in CNFTs (58.3%), but in acromegalies (80%), and prolactinomas (66.6%) most of the patients were female. Both of the craniopharingiomas were women as well. Headache was the predominant (52%) complaint for all the cases, visual disturbances (36%) and hypogonadal symptoms (16%) were the others. Hypogonadotropic hypogonadism and hypopituitarism were the most frequent endocrinologic abnormalities at admission. Eighteen of the patients were operated. In 10 (40%) of them transsphenoidal surgery, and in 8 (32%) transcranial surgery was performed. The recurrence rate was 22.2%. Hypopituitarism was increased up to 50% (n=9) from 28%, and sustained diabetes insipidus from 4% to 27.8% (n=5) postoperatively. Conclusion: Despite new treatment modalities in functioning adenomas promise expectations, pituitary macroadenomas seem to sustain as a dilemma especially for the endocrinologic dysfunctions in regards of tumor mass effect or operation sequels.
Açıklama
İnönü Üniversitesi Tıp Fakültesi Dergisi
11(3) 135-141 (2004)
Anahtar Kelimeler
Non-fonksiyone hipofiz adenomu, Prolaktinoma, Akromegali, Kranyofarinjioma, Non-functioning pituitary adenomas, Prolactinomas, Acromegaly, Craniopharingiomas
Kaynak
İnönü Üniversitesi Tıp Fakültesi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
11
Sayı
3
Künye
Çıkım, Ayşe ;Ateş, Özkan ;Keskin, Lezzan ;Çakır, Celal Özbek ; Çıkım, Kerim ;Tarım, Özcan ;İnönü Üniversitesi Tıp Fakültesi Dergisi 11(3) 135-141 (2004)
