Incidence, Hormonal Distribution and Postoperative Follow Up of Atypical Pituitary Adenomas

DURSUN, Engin; ŞAHİNOĞLU, Mert; NACAR, Osman Arıkan; ÜNAL, Tuba; DIVANLIOGLU, Denizhan; BELEN, Ahmed Deniz; YILDIRIM, Ali Erdem

Incidence, Hormonal Distribution and Postoperative Follow Up of Atypical Pituitary Adenomas

Ali Erdem YILDIRIM, (SB Ankara Numune Eğitim ve Araştırma Hastanesi, Nöroşirürji Kliniği, Ankara, Türkiye)

Denizhan DIVANLIOGLU, (SB Ankara Numune Eğitim ve Araştırma Hastanesi, Nöroşirürji Kliniği, Ankara, Türkiye)

Osman Arıkan NACAR, (SB Ankara Numune Eğitim ve Araştırma Hastanesi, Nöroşirürji Kliniği, Ankara, Türkiye)

Engin DURSUN, (Recep Tayyip Erdoğan Üniversitesi, Tıp Fakültesi, Rize, Türkiye)

Mert ŞAHİNOĞLU, (SB Ankara Numune Eğitim ve Araştırma Hastanesi, Nöroşirürji Kliniği, Ankara, Türkiye)

Tuba ÜNAL, (Ankara Numune Eğitim ve Araştırma Hastanesi, Patoloji Bölümü, Ankara, Türkiye)

Ahmed Deniz BELEN (SB Ankara Numune Eğitim ve Araştırma Hastanesi, Nöroşirürji Kliniği, Ankara, Türkiye)

Turkish Neurosurgery

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Yıl: 2013 Cilt: 23 Sayı: 2 Sayfa Aralığı: 226 - 231 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Incidence, Hormonal Distribution and Postoperative Follow Up of Atypical Pituitary Adenomas

Öz:

AMAÇ: Hipofiz adenomu tanısı ile operasyon uygulanan olgularımızdan patoloj ik tanısı atipik hipofiz adenomu olanların görülme sıklığı,hormonal aktivitesi ve postoperatif takipleri araştırılmıştır.YÖNTEM ve GEREÇlER: Kliniğimizde Ocak 2009 - Mayıs 2012 tarihleri arasında endoskopik endonasal transsfenoidal yolla opere edilen 146hipofiz adenomu olgusundan WHO 2004 kriterlerine göre patoloj isi atipik hipofiz adenomu olarak saptanan 13 olgu çalışmaya dahil edildi. BUlGULAR: Histoloj ik olarak 133 hasta tipik hipofiz adenomu (%91,1), 13 hasta ise atipik hipofiz adenomu (%8,9) idi. Bu hastaların 10 tanesierkek (%76,9), 3 tanesi kadındı (%23,1). Yaş dağılımı 27 ile 80 arasında idi (ortalama 52.7). Dokuz olgu nonsekretuar adenom (%69,3), 3 olguprolaktinoma (%23,1), 1 olgu ise somatostatinoma (%7,6) idi. Dört olguda hipofizer apopleksi mevcuttu (%30,7). Tipik hipofiz adenomluhastalardan 11 tanesinde nüks saptanırken (%8,2), atipik hipofiz adenomlu olgulardan ise 5 tanesinde nüks adenom (%38,4) nedeniyle tekraroperasyon yapıldı. SONUÇ: Atipik hipofiz adenomları iyi bir patoloj ik inceleme yapıldığında çok da nadir görülen adenom tipi değildir. Tümör rekürrensinde tekbaşına belirleyici olmamakla birlikte tipik adenomlara göre çok daha yüksek oranda rekürrense neden olduğu unutulmamalıdır. Bu yüzden buhastalarda total tümör eksizyonu, eğer mümkün olmuyorsa postoperatif daha yakın takip ile ek tedavi uygulamalarının kullanılması gereklidir.

Anahtar Kelime:

Konular: Cerrahi

Atipik Hipofiz Adenomu Olgularının İnsidansı, Hormonal Dağılımı ve Postoperatif Takibi

Öz:

AIM: To assess the incidence, hormonal activity and postoperative follow up of the cases that are histopathologically diagnosed as atypicalpituitary adenoma (APA) in our series.MATERIAL and METHODS: In this study, 13 atypical pituitary adenoma cases, by the WHO 2004 criteria, among the 146 pituitary adenomapatients operated on in our clinic between January 2009 and May 2012 by endoscopic endonasal transsphenoidal approach were included.results: In histological studies, 133 cases were diagnosed as typical pituitary adenoma (91.1%) and 13 cases were APAs (8.9%) of which 10were male (76.9%) and 3 were female (23.1%), ranged between 27 and 80 (mean 52.7) ages. Histopathological distribution of APAs was 9 non- secretory adenomas (69.3%), 3 prolactinomas (23.1%) and 1 somatostatinoma (7.6%). Asymptomatic pituitary apoplexy was diagnosed in 4cases (30.7%). Eleven cases of typical pituitary adenomas (8.2%) and 5 cases of the atypical pituitary adenomas (38.4%) were re-operated dueto tumor recurrences.CONCLUSION: Accurate histopathological examination shows that atypical pituitary adenoma is not a rare disease. Although it is not the onlydeterminant, APAs are more prone to recurrence than typical adenomas. In our opinion, if total resection is not possible for the patients withAPA, close postoperative follow up and additional curative therapy modalities are needed.

Anahtar Kelime:

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	YILDIRIM A, DIVANLIOGLU D, NACAR O, DURSUN E, ŞAHİNOĞLU M, ÜNAL T, BELEN A (2013). Incidence, Hormonal Distribution and Postoperative Follow Up of Atypical Pituitary Adenomas. , 226 - 231.
Chicago	YILDIRIM Ali Erdem,DIVANLIOGLU Denizhan,NACAR Osman Arıkan,DURSUN Engin,ŞAHİNOĞLU Mert,ÜNAL Tuba,BELEN Ahmed Deniz Incidence, Hormonal Distribution and Postoperative Follow Up of Atypical Pituitary Adenomas. (2013): 226 - 231.
MLA	YILDIRIM Ali Erdem,DIVANLIOGLU Denizhan,NACAR Osman Arıkan,DURSUN Engin,ŞAHİNOĞLU Mert,ÜNAL Tuba,BELEN Ahmed Deniz Incidence, Hormonal Distribution and Postoperative Follow Up of Atypical Pituitary Adenomas. , 2013, ss.226 - 231.
AMA	YILDIRIM A,DIVANLIOGLU D,NACAR O,DURSUN E,ŞAHİNOĞLU M,ÜNAL T,BELEN A Incidence, Hormonal Distribution and Postoperative Follow Up of Atypical Pituitary Adenomas. . 2013; 226 - 231.
Vancouver	YILDIRIM A,DIVANLIOGLU D,NACAR O,DURSUN E,ŞAHİNOĞLU M,ÜNAL T,BELEN A Incidence, Hormonal Distribution and Postoperative Follow Up of Atypical Pituitary Adenomas. . 2013; 226 - 231.
IEEE	YILDIRIM A,DIVANLIOGLU D,NACAR O,DURSUN E,ŞAHİNOĞLU M,ÜNAL T,BELEN A "Incidence, Hormonal Distribution and Postoperative Follow Up of Atypical Pituitary Adenomas." , ss.226 - 231, 2013.
ISNAD	YILDIRIM, Ali Erdem vd. "Incidence, Hormonal Distribution and Postoperative Follow Up of Atypical Pituitary Adenomas". (2013), 226-231.

APA	YILDIRIM A, DIVANLIOGLU D, NACAR O, DURSUN E, ŞAHİNOĞLU M, ÜNAL T, BELEN A (2013). Incidence, Hormonal Distribution and Postoperative Follow Up of Atypical Pituitary Adenomas. Turkish Neurosurgery, 23(2), 226 - 231.
Chicago	YILDIRIM Ali Erdem,DIVANLIOGLU Denizhan,NACAR Osman Arıkan,DURSUN Engin,ŞAHİNOĞLU Mert,ÜNAL Tuba,BELEN Ahmed Deniz Incidence, Hormonal Distribution and Postoperative Follow Up of Atypical Pituitary Adenomas. Turkish Neurosurgery 23, no.2 (2013): 226 - 231.
MLA	YILDIRIM Ali Erdem,DIVANLIOGLU Denizhan,NACAR Osman Arıkan,DURSUN Engin,ŞAHİNOĞLU Mert,ÜNAL Tuba,BELEN Ahmed Deniz Incidence, Hormonal Distribution and Postoperative Follow Up of Atypical Pituitary Adenomas. Turkish Neurosurgery, vol.23, no.2, 2013, ss.226 - 231.
AMA	YILDIRIM A,DIVANLIOGLU D,NACAR O,DURSUN E,ŞAHİNOĞLU M,ÜNAL T,BELEN A Incidence, Hormonal Distribution and Postoperative Follow Up of Atypical Pituitary Adenomas. Turkish Neurosurgery. 2013; 23(2): 226 - 231.
Vancouver	YILDIRIM A,DIVANLIOGLU D,NACAR O,DURSUN E,ŞAHİNOĞLU M,ÜNAL T,BELEN A Incidence, Hormonal Distribution and Postoperative Follow Up of Atypical Pituitary Adenomas. Turkish Neurosurgery. 2013; 23(2): 226 - 231.
IEEE	YILDIRIM A,DIVANLIOGLU D,NACAR O,DURSUN E,ŞAHİNOĞLU M,ÜNAL T,BELEN A "Incidence, Hormonal Distribution and Postoperative Follow Up of Atypical Pituitary Adenomas." Turkish Neurosurgery, 23, ss.226 - 231, 2013.
ISNAD	YILDIRIM, Ali Erdem vd. "Incidence, Hormonal Distribution and Postoperative Follow Up of Atypical Pituitary Adenomas". Turkish Neurosurgery 23/2 (2013), 226-231.