Acromegaly associated with GIST, non-small cell lung carcinoma, clear cell renal carcinoma, multiple myeloma, medulla oblongata tumour, adrenal adenoma, and follicular thyroid nodules

Abstract

Acromegaly is associated with increased growth hormone (GH) and insulin-like growth factor-I (IGF-I) secretion which may support tumour development and growth. A 68-year-old woman was diagnosed with acromegaly due to typical clinical and hormonal characteristics. While contrast-enhanced MRI at diagnosis did not reveal a pituitary adenoma, a 5-mm lesion was identified on repeat scanning 13 months later. Abdominal and chest CT showed tumours of the stomach, right adrenal gland, and right lung. The CT also showed a hypodense lesion in the liver and heterogeneous echostructure of the thyroid gland with left lobe solid-cystic tumour. Somatostatin receptor scintigraphy revealed increased tracer accumulation in the right thyroid lobe. No tracer accumulation was noted at the location of the other tumours. The resected stomach, adrenal, chest, and thyroid lesions did not show GH secretion. The patient refused pituitary surgery, and her acromegaly is currently well-controlled with somatostatin analogue therapy. A CT scan 19 months later revealed a contrast-enhancing left kidney tumour that was a G1-grade clear cell carcinoma. Four years after the acromegaly diagnosis multiple myeloma were diagnosed with secondary renal amyloidosis. Genetic screening for a paraganglioma gene panel, AIP, MEN1, and CDKN1B mutations were negative. A next-generation cancer panel containing 94 cancer genes did not identify any possible unifying gene abnormality in her germline DNA. Coexistence of acromegaly and numerous other tumours suggests a common aetiology of these disorders. However, no genetic abnormality could be identified with the tests that have been performed.

Therapeutic Targeting of the IGF Axis

“…Subjects with acromegaly, which is due to excessive GH secretion, have elevated levels of serum IGF-1 and are well-recognized to be at increased risk of colorectal cancer, with possible association also with breast, thyroid and prostate cancers and a recent report of multiple additional tumors including cancers of the lung, kidney, adrenal and GIST [74,75]. There are additional health risks associated with chronic exposure to high circulating IGF-1, including increasing bone fragility.…”

Akromegali hastalarında üst gastrointestinal system endoskopi taramasının değerlendirilmesi: tek merkez deneyimi

“…However, there are patients in the literature in whom multiple cancers coexist that have been presented as case reports. In a case report presented by Aleksandra et al, although no genetic predisposition was found, GIST, non-small cell lung carcinoma, clear cell renal carcinoma, multiple myeloma, medulla oblongata tumor, adrenal adenoma, and follicular thyroid nodules were detected in the same patient 23 . In a case report presented in 1997, four types of tumors were found in the same patient: gastric cancer, colon tubular adenoma with moderate atypia, pancreatic mucinous cystadenoma, and subcutaneous lipoma 24 .…”

The importance of oncological alertness in the differential diagnosis of inflammatory changes in the lungsdetected as a result of differential diagnosis of pneumonia

“…По литературным данным, на сегодняшний день всего в мире описаны 8 случаев сочетания ММ и рака легкого [9][10][11][12][13][14][15]. Соотношение женщин к мужчинам -3:5.…”