članak: 1 od 1  
Glasnik Instituta za štitastu žlezdu i metabolizam "Zlatibor"
2003, vol. 6, br. 7, str. 57-65
jezik rada: srpski
neklasifikovan
Incidentalomi i hipertenzija
Univerzitet u Beogradu, Medicinski fakultet, Klinički centar Srbije

e-adresa: menopauza@beotel.yu

Sažetak

Učestalost incidentaloma nadbubrega je u porastu zbog poboljšanja vizuelizacione tehnike koja danas stoji na raspoloženju. Trodimenzionalna ehosonografija i trodimenzionalna magnetna rezonanca će sigurno imati uticaja na ranu detekciju ovih tumora u većem procentu. Prevalenca raste sa starošću i posebno je visoka u pacijenata sa slikom metaboličkog sindroma (gojaznost, arterijskahipertenzija, insulinska rezistencija). U našoj grupi ispitanika bilo je od 103 osobe, starosti od 28 do 76 godina, u kojoj je bilo 75 žena i 28 muškaraca. Hormonski inaktivan incidentalom nađen je 57%, subklinički Gushing 15.8%, feohromocitom 2.8%, Conn 0.9%, metastaze 8.7%, hemoragična cista 3.9%, mijelolipom 2.8%, bilateralna nodularnahiperplazija l .9%, MEN Пa, ehinokokna cista i adenokarcinom 0.9%. Definitivna dijagnoza postavljena je na osnovu operativnog nalaza(27.1%) ili FNA(3.8%). Gojazno je bilo 61%, a 57.2%je imalo hipertenziju. Endokrinološka ispitivanja (24-h kateholamini/metanefrin, supresioni test sa deksazonom, aldosteron/PRA) omogućuju dijagnozu subkliničkih bolesti (feohromocitoma, hiperkorticizma i hiperaldosteronizma). Rizik od maligniteta se povećava sa veličinom tumora. Za predlog o terapiji incidentaloma korisni parametri su veličina i hormonska aktivnost tumora. Svi tumori veći od 6 cm treba da budu operisani. Tumori od 4-6 cm zahtevaju praćenje i treba ih operisati ukoliko pokažu tendenciju rasta.

Ključne reči

incidentalom; subklinički Cushingov sindrom(SCS); feohromocitom; Connov adenom

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