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DAĞÇINAR, ADNAN

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DAĞÇINAR

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    Challenges in the management of a 7 years old child with thyrotropin-secreting pituitary adenoma and the review of the literature
    (2023-01-01) KIRKGÖZ, TARIK; GÜRPINAR TOSUN, BUŞRA; ELTAN, MEHMET; HALİLOĞLU, BELMA; KAYGUSUZ, SARE BETÜL; SEVEN MENEVŞE, TUBA; BOZKURT, SÜHEYLA; ÖNEŞ, TUNÇ; GÜRAN, TÜLAY; DAĞÇINAR, ADNAN; BEREKET, ABDULLAH; DEMİRCİOĞLU, SERAP; KIRKGÖZ T., Abali S., Seker A., GÜRPINAR TOSUN B., ELTAN M., Helvacioglu D., HALİLOĞLU B., KAYGUSUZ S. B., Yavas Abali Z., SEVEN MENEVŞE T., et al.
    Introduction: Thyrotropin-producing pituitary adenoma (TSHoma) is a very rare disease, representing less than 1% of the pituitary tumours, present with elevated thyroid hormones and normal/high TSH concentrations. Case Presentation: A 7-year-old boy with nervousness was referred by his psychiatrist for elevated free T4, T3 and TSH levels. Initial evaluation revealed an elevated -subunit.Pituitary MRI demonstrated a macroadenoma. The patient underwent a trans-sphenoidal tumour resection (TSS) which showed positive immunohistochemical staining for TSH, growth hormone, and prolactin in tumoral tissue. Euthyroidism was achieved for one year after TSS, then, recurrence of tumour with elevated TSH and thyroid hormone levels necessitated a re-operation with TSS followed by gamma-knife radiosurgery. The euthyroid state was achieved and lasted for 2.5 years this time, but, due to the recurrence, medical treatment had been commenced with cabergoline and octreotide. Euthyroidism was maintained for the last 4 years on monthly octreotide treatment. A repeat MRI demonstrated no pituitary mass but a mass in the sphenoidal sinus had been detected. Removal of this mass by surgery did not achieve euthyroidism. 68Ga-DOTA-TATE PET/CT showed residual tissue extending from the pituitary region to the sphenoid sinus.The patient\"s bone age was advanced 2 years at diagnosis which became 4 years in one year after the diagnosis and remained so throughout follow-up, leading to a final height of -3.3 SDS below his target height at the age of 16 years. Conclusion: The diagnosis, treatment, and follow-up of TSHomas are challenging and short stature due to accelerated bone maturation is a complication of paediatric TSHomas.
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    Pediatrik dev torakolumbosakral araknoid kiste bağlı kord herniasyonu olgusu
    (2021-10-31) OĞLİN, VOLKAN; BAYRİ, YAŞAR; DAĞÇINAR, ADNAN; ŞİMŞEK, İSMAİL; SAKAR, MUSTAFA; SÖNMEZ, ÖZCAN; Şimşek I., Oğlin V., Sönmez Ö., Sakar M., Bayri Y., Dağçinar A.
    Araknoid kistler; araknoid membranın altında oluşan selim, neoplazi içermeyen, içi sıvı dolu yapılardır. Bu kistler genellikle insidental olarakgörüntülemeler sırasında saptanır ve belirti vermedikçe tedavi edilmeleri gerekmez. Semptomatik olduklarındaysa; valsalva manevralarıylaartabilen sırt ve bel ağrısı, radiküler ağrı veya kronik miyelopati gibi bulgu ve belirtilere sebep olabilirler (4).Pediatrik yaşta daha sık görülen araknoid kistler, genellikle konjenitaldir (1). Spinal araknoid kistler dahaçok torakal seviyelerde ve vertebranın dorsalinde konumlanırlar. Ortalama üç vertebra uzunluğundadırlar veT3-T6 seviyeleri arasında daha sık görülürler (5). Dev araknoid kistler nadirdir ve bugüne kadar literatürde çokaz sayıda vaka bildirilmiştir (3,6). Çalışmamızdaki amacımız kliniğimizde tedavi edilmiş dev araknoid kist olgusunun yönetimini sunmaktır
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    Septal DNET: Nadir bir olgu sunumu
    (2021-10-31) ÇEKİÇ, EFECAN; YARALI, AHMET TUĞRUL; SAKAR, MUSTAFA; BAYRİ, YAŞAR; DAĞÇINAR, ADNAN; ŞİMŞEK, İSMAİL; Şimşek I., Yılmaz N., Çekiç E., Yarali A. T., Sakar M., Bayri Y., Dağçinar A.
    Disembriyoplastik nöroepitelyal tümörler sıklıkla çocukluk çağında,dirençli epilepsi ile bulgu veren ve genellikle temporal yerleşimli tümörlerdir.Ekstraaksiyal yerleşimi nadir görülmekte olup daha çok intraventriküler,kaudat ve septum pellucidumda görülür.Septal DNET,DNET in bir varyantı olarak görülse de adölesan yaş grubunda KİBAS bulgularıyla prezente olur.Benign seyirlidir,adjuvan terapi ihtiyacı olmaz.Çalışmamızda hastanemize başvuran böyle bir vakanın takdimini amaçlamaktayız.
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    Different C2 Screw Placement Technique Wıth Mobilization of the Vertebral Artery In High-Riding Vertebral Artery Cases: Cadaver Dıssectıon
    (2023-06-01) HARMAN, FERHAT; OĞLİN, VOLKAN; DAĞÇINAR, ADNAN; Harman F., Oğlin V., Yılmaz Ö., Baran O., Böyükyılmaz Ş., Gezercan Y., Dalbayrak S., Dağçınar A.
    Aim: In neurosurgery, posterior approaches intended at the craniovertebral junction are frequently used. The most popular procedures for treating upper cervical instability are C1 lateral mass, C2 pedicle, and C1-C2 transarticular screw stabilization. Due to their proximity to neural structures and the presence of the high-riding vertebral artery, these techniques are complicated. By mobilizing the vertebral artery, the risk of VA damage can be decreased. Using cadaveric specimens in this study was aimed to demonstrate C2 pedicle and C1-C2 transarticular screw placement with vertebral artery mobilization and a novel C2 screw placement technique Method: In this study, twelve adult cadaveric specimens and two adult dry cadaveric C2 bones were used with the permission and decision of the University Research Ethics Committee. Colored silicone was injected into the arteries and veins of these twelve cadaveric specimens. Then, muscle dissection was performed stepwise, and the C2 vertebrae of the cadavers were revealed with a Surgical Microscope. Each specimen and entire stages of the dissections were recorded photographically. After cadaver dissections were completed and screw placement was performed with three different techniques, radiological imaging was done with fluoroscopy. Results: After dissection, the lateral mass of the C2 vertebra was observed, and lateral to it the transverse process and foramen were detected with the help of a hook. Next, the posterior wall of the vertebral artery groove was removed until the vertebral artery loop could partially be observed to mobilize the vertebral artery using a 1 mm thin plate Kerrison rongeur. This enables us to find the top of the loop of the vertebral artery and mobilize it inferiorly by using a dissector. Following this step, the C1-2 transarticular, C2 pedicle, and the novel C2 inferior corpus screw placement can be performed safely by directly visualizing the artery (Figure 1). Conclusion: Due to the nearby neurologic and vascular structures, placing the C2 pedicle and C1-2 transarticular screw is a challenging procedure, especially in high-riding vertebral artery cases. However, it is possible to place the C2 pedicle, C1-2 transarticular, and novel C2 inferior corpus screw after the mobilization of the vertebral artery. This study aimed to show all of them together on a cadaver for the first time, to understand the anatomy of the C2 vertebra, and to use screw placement techniques to minimize the risk of complications.