Acromegalia ectópica por carcinoide bronquial

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.

Acromegaly with No Evidence of Pituitary Adenoma or Ectopic Source

“…Very small microadenomas that are not visible on pituitary MRI are rare and could be identified on pituitary exploration (4). Ectopic GH-or growth hormone-releasing hormone (GHRH)-secreting tumors are a rare cause of acromegaly (5). Most frequently bronchial and pancreatic carcinoid tumors and less frequently pancreatic islet tumors, pheochromocytomas, medullary thyroid carcinomas, and small cell carcinomas of the lung are the sources of ectopic acromegaly because of GHRH secretion (6-10).…”