Çocukluk çağı kraniyofaringiyoma olgularının klinik ve laboratuvar bulguları
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Date
2020-06-20
Authors
Söbü, Elif
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Publisher
Bursa Uludağ Üniversitesi
Abstract
Bu çalışmada çocukluk çağı kraniyofaringioma olgularının klinik ve laboratuar bulguları ve izlem süresince karşılaşılan endokrin sorunların değerlendirilmesi amaçlanmıştır. Çalışmaya Ocak 2010-Aralık 2017 arasında kraniyofaringiyoma tanısı alan olgular dahil edildi. Demografik ve klinik veriler Uludağ Üniversitesi Tıp Fakültesi Çocuk Endokrinoloji poliklinik dosyalarından retrospektif olarak değerlendirildi. İstatistiksel analizler için SPSS software version 21 kullanıldı. Sekiz yıllık süreçte tanı alan 28 olgu çalışmaya dahil edildi. Olguların yaşları 60-207 ay arasında değişmekte olup median yaş 138,5 aydı. Cinsiyet dağılımlarına bakıldığında %53 erkek(n=15) ve %47 kızdı (n=13). En sık başvuru bulguları sırayla başağrısı, görme bozuklukları ve boy kısalığıydı. Tanı anında olguların %71’inde (n: 20) tümör boyutu 3 cm’den büyüktü. Preoperatif dönemde büyüme hormonu eksikliği %17(n=5) ve hipotiroidizm %14(n=4), hipokortizolemi %10 (n=3), diyabet insipit %7,1(n=2) sıklıkta saptandı. Postoperatif dönemde olguların %89,3’ünde çoklu hipofizer hormon eksikliği saptandı. Kraniyofaringiyomalar yavaş büyüyen tümörler olup genellikle geç tanı alır. Geç tanı ve tümör boyutunun büyük olması sıklıkla endokrin kayıpların daha ciddi olmasına yol açar. Büyümede duraksama ve ilerleyici kilo artışı hipofizer kitlelerin erken tanısı açısından uyarıcı bulgulardır.
The aim of this study was to evaluate the clinical and laboratory findings and follow up of endocrine status of pediatric craniopharyngioma cases. The patients diagnosed with craniopharyngioma between January 2010-December 2017 were included in this study. Demographic and clinical findings were retrospectively examined from medical records of Uludag University Medical Faculty Pediatric Endocinology Department. Statistical analyses were performed using the SPSS software version 21. We identified a total of 28 patients with craniopharyngioma during this period. The age of the patients ranged from 60 to 207 months, with a median age of138.5months.Fifty-three percent (n=15) of cases were male and forty-seven percent (n=13) of the cases were female.The most common presenting complaints were headache, visual impairment, and short stature in decreasing order. Tumor size was greater than 3 cm in 71% (n: 20) of patients at the time of diagnosis. When the endocrine status of the patients were examined in the preoperative period, it was determined that 17% (n: 5) of the cases had growth hormone deficiency, 14% (n: 4) had hypothyroidism, 10%(n: 3) had cortisol deficiency, and 7.1% (n: 2) had diabetes insipidus. In the postoperative period, panhypopituitarism developed in 89.3% (n: 25) of the cases. Craniopharyngiomas are slow-growing tumors, the tumor is usually diagnosed lateand reaches large sizes. Late diagnosis and large tumor size often lead to more serious endocrine losses. Failure to thrive and progressive weight gain are stimulating findings for early diagnosis of pituitary masses.
The aim of this study was to evaluate the clinical and laboratory findings and follow up of endocrine status of pediatric craniopharyngioma cases. The patients diagnosed with craniopharyngioma between January 2010-December 2017 were included in this study. Demographic and clinical findings were retrospectively examined from medical records of Uludag University Medical Faculty Pediatric Endocinology Department. Statistical analyses were performed using the SPSS software version 21. We identified a total of 28 patients with craniopharyngioma during this period. The age of the patients ranged from 60 to 207 months, with a median age of138.5months.Fifty-three percent (n=15) of cases were male and forty-seven percent (n=13) of the cases were female.The most common presenting complaints were headache, visual impairment, and short stature in decreasing order. Tumor size was greater than 3 cm in 71% (n: 20) of patients at the time of diagnosis. When the endocrine status of the patients were examined in the preoperative period, it was determined that 17% (n: 5) of the cases had growth hormone deficiency, 14% (n: 4) had hypothyroidism, 10%(n: 3) had cortisol deficiency, and 7.1% (n: 2) had diabetes insipidus. In the postoperative period, panhypopituitarism developed in 89.3% (n: 25) of the cases. Craniopharyngiomas are slow-growing tumors, the tumor is usually diagnosed lateand reaches large sizes. Late diagnosis and large tumor size often lead to more serious endocrine losses. Failure to thrive and progressive weight gain are stimulating findings for early diagnosis of pituitary masses.
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Keywords
Kraniyofaingiyoma, Craniopharyngioma, Santral hipotiroidi, Hipopituitarizm, Central hypothyroidism, Hypopituitarism
Citation
Söbü, E. vd. (2020). "Çocukluk çağı kraniyofaringiyoma olgularının klinik ve laboratuvar bulguları". Bursa Uludağ Üniversitesi Güncel Pediatri, 18(3), 403-410.