Ectopic acromegaly due to a bronchial carcinoid
Keywords:
Ectopic acromegaly. GHRH ectopy. Bronchial carcinoid. Neuroendocrine tumor.Abstract
Tumours that cause ectopic acromegaly can do so through the secretion of GH or GHRH. One hundred cases of ectopic acromegaly due to secretion of GHRH have been described. Given the rarity of this pathology, we present a clinical case with the aim of contributing our diagnostic-therapeutic experience and the subsequent follow-up.
We present the case of a patient with acromegaloid physical features that had evolved over several years. Concomitantly, he also presented other accompanying symptoms that were suggestive of a possible bronchial origin. Facing the clinical suspicion of acromegaly, we opted to confirm it biochemically and subsequently through image study. A hypophysary origin was ruled out, so we carried out screening for a bronchial neuroendocrine and/or gastrointestinal tumor as they are the most frequent localizations. The treatment of choice was surgical resection.
Downloads
References
1. FORGA L, ANDA E, MARTÍNEZ JP. Síndromes hormonales paraneoplásicos. An Sist Sanit Navar 2005; 28: 213-226.
https://doi.org/10.4321/S1137-66272005000300006
2. GHAZI A, AMIRBAIGLOO A, DEZFOOLI AA, SAADAT N, GHAZI S, POURAFKARI M et al. Ectopic acromegaly due to growth hormone releasing hormone. Endocrine 2013; 43: 293-302.
https://doi.org/10.1007/s12020-012-9790-0
3. BOLLANTI L, RIONDINO G, STROLLO F. Endocrine paraneoplastic syndromes with special reference to the elderly. Endocrine 2001; 14: 151-157.
https://doi.org/10.1385/ENDO:14:2:151
4. DELELLIS RA, XIA L. Paraneoplastic endocrine syndromes: a review. Endocrine Pathol 2003; 14: 303-317.
https://doi.org/10.1385/EP:14:4:303
5. NEWELL-PRICE J. Propiomelanocortin gene expression and DNA methylation: implications for Cushing's síndrome and beyond. J Endocrinol 2003; 177: 365-372.
https://doi.org/10.1677/joe.0.1770365
6. CHANSON P, SALENAVE S. Acromegaly review. Orphanet J Rare Dis 2008; 3: 1-17.
https://doi.org/10.1186/1750-1172-3-17
7. GARBY L, CARON P, CLAUSTRAT F, CHANSON P, TABARIN A, ROHMER V et al. Clinical characteristics and outcome of acromegaly induced by ectopic secretion of Growth Hormone-Releasing Hormone (GHRH): A French nationwide series of 21 cases. J Clin Endocrinol Metab 2012; 97: 2093-2104.
https://doi.org/10.1210/jc.2011-2930
8. BOLANOWSKI M, SCHOPOHL J, MARCINIAK M, RZESZUTKO M, ZATONSKA K, DAROSZEWSKI J et al. Acromegaly due to GHRH-secreting large bronchial carcinoid. Complete recovery following tumor surgery. Exp Clin Endocrinol Diabetes 2002; 110: 188-192.
https://doi.org/10.1055/s-2002-32151
9. GOLA M, DOGA M, BONADONNA S, MAZZIOTTI G, VESCOVI PP, GIUSTINA A. Neuroendocrine tumors secreting growth hormone-releasing hormone: Pathophysiological and clinical aspects. Pituitary 2006; 9: 221-229.
https://doi.org/10.1007/s11102-006-0267-0
10. BOIX E, PICÓ A, PINEDO R, ARANDA I, KOVACS K. Ectopic growth hormone-releasing hormone secretion by thymic carcinoid tumour. Clin Endocrinol (Oxf) 2002; 57: 131-134.
https://doi.org/10.1046/j.1365-2265.2002.01535.x
11. FESSLER MB, COOL CD, MILLER YE, SCHWARZ MI, BROWN KK. Idiopathic diffuse hyperplasia of pulmonary neuroendocrine cells in a patient with acromegaly. Respirology 2004; 9: 274-277.
https://doi.org/10.1111/j.1440-1843.2004.00571.x
12. MITSUYA K, NAKASU Y, NIOKA H, NAKASU S. Ectopic growth hormone releasing adenoma in the cavernous sinus. Neurol Med Chir (Tokyo) 2004; 44: 380-385.
https://doi.org/10.2176/nmc.44.380
13. BORSON-CHAZOT F, GARBY L, RAVEROT G, CLAUSTRAT F, RAVEROT V, SASSOLAS G. Acromegaly induced by ectopic secretion of GHRH: A review 30 years after GHRH discovery. Ann Endocrinol (Paris) 2012; 73: 497-502.
https://doi.org/10.1016/j.ando.2012.09.004
14. SHOBACK D, FUNK J. Humoral manifestations of malignancy. En: Greenspan FS y Gardner DG Editores. Basic and Clinical Endocrinology. New York Lange Medical Books/Mc Graw-Hill 1997; 778-791
Published
How to Cite
Issue
Section
License
Copyright (c) 2014 Anales del Sistema Sanitario de Navarra
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
La revista Anales del Sistema Sanitario de Navarra es publicada por el Departamento de Salud del Gobierno de Navarra (España), quien conserva los derechos patrimoniales (copyright ) sobre el artículo publicado y favorece y permite la difusión del mismo bajo licencia Creative Commons Reconocimiento-CompartirIgual 4.0 Internacional (CC BY-SA 4.0). Esta licencia permite copiar, usar, difundir, transmitir y exponer públicamente el artículo, siempre que siempre que se cite la autoría y la publicación inicial en Anales del Sistema Sanitario de Navarra, y se distinga la existencia de esta licencia de uso.
