10 yıllık feokromasitoma deneyimi ve literatüre bakış
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Date
2009-02-11
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Uludağ Üniversitesi
Abstract
Çalışmamızın Amacı feokromasitoma tanısı ile takip edilen hastalarda elde edilen bulguların incelenmesi ve literatür verileri ile karşılaştırılmasıdır. Araştırmamızda 1997–2007 yılları arasında bölümümüze başvuran hastalardan feokromasitoma tanısı almış 16 olguya ait veriler retrospektif olarak incelenmiştir. 10 yıllık dönemde yaşları 49,8±14,5 yıl olan 9 erkek, 7 kadın toplam 16 feokromasitoma olgusu tespit edildi. 16 olgunun 14’ünde 2–8 yıllık hipertansiyon (HT) öyküsü varken, 2 olguya ilk başvuru anında tanı konuldu. 13 olgu ataklar şeklinde, 1 olguda ise kronik HT mevcuttu. 6 hasta ataklar sırasında olmak üzere toplam 11 hasta antihipertansif tedavi alırken, 5 hasta ise herhangi bir tedavi almıyordu. Hipertansif ataklara en sık çarpıntı (%68,7), terleme (%68,7) ve baş ağrısı (%62,5) eşlik ediyordu. 14 hastaya (%87,5) total kitle eksizyonu gerçekleştirilirken, 2 hasta opere edilemedi. Opere olguların 10’unda (%73,3) HT kür ile sonuçlanırken, 4 (%26,6) olguya tekrar antihipertansif tedavi başlandı. MEN-2A’lı ve malign feokromasitomalı 2 hasta progresyon veya akut komplikasyon nedeniyle kaybedilirken, 1 hasta ise tümor nüksü sonrası hayatını kaybetmiş olup 13 olgunun poliklinik kontrolleri halen devam etmektedir. Feokromasitoma ön tanılı hastalarda özellikle ataklar sırasında spesifik laboratuvar incelemeleri yapılmalı ve görüntüleme yöntemleri ile tanı konulan hastalara cerrahi tedavi uygulanmalıdır. Bu tedavi ile kür sağlanabilir ve anti hipertansif tedavi ihtiyacı ortadan kalkabilirken, eşlik edebilen hastalıklar ve nüks açısından hastalar yakın takip edilmelidir.
The objective of this study was to analyze the data obtained from the patients having pheochromocytoma and to compare these data with the literature. In this study, we retrospectively evaluated the data of 16 cases admitted to our department between 1997 and 2007, and diagnosed as having phemochromocytoma. In ten years period, a total of 16 pheochromocytoma cases, 9 male and 7 female, aged 49.8±14.5 were included. Among 16 cases 14 had an anamnesis of hypertension for 2-8 years and 2 were newly diagnosed as hypertensive in their first admissions. 13 cases had hypertensive attacks and one case had chronic hypertension. A total of 11 patients, 6 of them during the hypertensive attacks, recieved antihipertensive drugs. 5 patients did not have any treatment. Tachycardia (68.7%), sweating (68.7%) and headache (62.5%) were accompanying hypertensive attacks. 14 patients (87.5%) underwent total mass excision surgery, but two patients could not be operated. Ten of the operated cases cured for hypertension, for 4 cases the antihipertensive treatment had to be repeated. Two patients with MEN-2A and one with malign pheochromocytoma died from progression of the disease or acute complications, the other 13 patients are still under follow-up. The patients who had prediagnosis of pheochromocytoma have to be evaluated with special laboratory examinations especially during attacks, and the ones who are diagnosed radiologically have to be treated surgically. With this treatment, cure can be achieved and the need for antihypertensive treatment may be not required, but these patients have to be followed for the other accompanying diseases and recurrences.
The objective of this study was to analyze the data obtained from the patients having pheochromocytoma and to compare these data with the literature. In this study, we retrospectively evaluated the data of 16 cases admitted to our department between 1997 and 2007, and diagnosed as having phemochromocytoma. In ten years period, a total of 16 pheochromocytoma cases, 9 male and 7 female, aged 49.8±14.5 were included. Among 16 cases 14 had an anamnesis of hypertension for 2-8 years and 2 were newly diagnosed as hypertensive in their first admissions. 13 cases had hypertensive attacks and one case had chronic hypertension. A total of 11 patients, 6 of them during the hypertensive attacks, recieved antihipertensive drugs. 5 patients did not have any treatment. Tachycardia (68.7%), sweating (68.7%) and headache (62.5%) were accompanying hypertensive attacks. 14 patients (87.5%) underwent total mass excision surgery, but two patients could not be operated. Ten of the operated cases cured for hypertension, for 4 cases the antihipertensive treatment had to be repeated. Two patients with MEN-2A and one with malign pheochromocytoma died from progression of the disease or acute complications, the other 13 patients are still under follow-up. The patients who had prediagnosis of pheochromocytoma have to be evaluated with special laboratory examinations especially during attacks, and the ones who are diagnosed radiologically have to be treated surgically. With this treatment, cure can be achieved and the need for antihypertensive treatment may be not required, but these patients have to be followed for the other accompanying diseases and recurrences.
Description
Bu makale 21 Şubat-24 Şubat 2008 tarihleri arasında Bursa’da yapılan 4. Uludağ İç Hastalıkları Kış Kongresinde sözlü bildiri olarak sunulmuştur.
Keywords
Hipertansiyon, Hipertansif atak, Cerrahi tedavi, Feokromasitoma, Hypertensive attack, Hypertension, Surgical treatment, Pheochromocytoma
Citation
Serin, S. O. vd. (2009). ''10 yıllık feokromasitoma deneyimi ve literatüre bakış''. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 35(1), 11-16.