Acromegaly Caused by Ectopic Growth Hormone: A Rare Manifestation of a Bronchial Carcinoid

Biswal, Suvakanta; Srinivasan, Balamurali; Dutta, Pinaki; Ranjan, Prabat; Vaiphei, Kim; Singh, Ramandeep; Thingnam, Shyamkumar Singh

doi:10.1016/j.athoracsur.2007.06.072

Cited by 20 publications

(9 citation statements)

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“…[5,6] Out of the 271 patients, 18 (6.6%) had a microadenoma, 26 (9.6%) had a mesoadenoma (intrasellar microadenoma) while the rest (83%) harbored a pituitary macroadenoma (including 44 (19.5%) patients with a giant adenoma (≥4 cms in any diameter). One patient had an adenoma in an ectopic location (a pharyngeal pituitary adenoma).…”

Section: Aetiologymentioning

confidence: 99%

Clinical profile and outcome of patients with acromegaly according to the 2014 consensus guidelines: Impact of a multi-disciplinary team

et al. 2015

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Section: Aetiologymentioning

confidence: 99%

Clinical profile and outcome of patients with acromegaly according to the 2014 consensus guidelines: Impact of a multi-disciplinary team

et al. 2015

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“…Majority of the cases were due to pituitary adenomas with two cases being due to ectopic GH and growth hormone-releasing hormone (GHRH) secretion. [5,6] Out of the 271 patients, 18 (6.6%) had a microadenoma, 26 (9.6%) had a mesoadenoma (intrasellar microadenoma) while the rest (83%) harbored a pituitary macroadenoma (including 44 (19.5%) patients with a giant adenoma (≥4 cms in any diameter). One patient had an adenoma in an ectopic location (a pharyngeal pituitary adenoma).…”

Section: Aetiologymentioning

confidence: 99%

Can Immediate Post-Operative Random Growth Hormone Levels Predict Long Term Cure in Patients with Acromegaly?

et al. 2016

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Aim: The diagnosis and treatment of acromegaly, a rare and possibly curable disease, has undergone a paradigm shift in the past few decades. Our aim was to study the changing trends in clinical presentation, management and outcome of the disease in the last fifteen years. Methodology: 271 consecutive patients with acromegaly treated at the Departments of Endocrinology and Neurosurgery, PGIMER, Chandigarh, between 2000 and 2014, were included in the study. Clinical and hormonal profiles, comorbidities, treatment modalities, outcome and mortality data were evaluated. The cure rate was assessed according to the present consensus criteria. Results: The gender distribution was equal with the mean age (±SD) of 37.1 ± 12.3 years at diagnosis. The average lag period to diagnosis was 4.7 ± 4.2 years. The most common presenting manifestations were acral enlargement and headache followed by visual deficits. The overall mortality rate was 5%, with the perioperative mortality being 1.5%. The most prevalent comorbidities in our series were hypertension (17.7%), diabetes mellitus (16.2%), arthropathy (11.8%) and obstructive sleep apnea (10.3%). Overall, 2 patients in our series suffered from extra-pituitary neoplasms and 12 patients had apoplexy as the presenting manifestation. As per the present consensus criteria, the cure rate in our series was 28.5%. The cure rate was only 7.9% when many surgeons were operating. It increased to 25.5% when surgeries were being performed by one surgeon exclusively; and, when a sub-specialty clinic exclusively for pituitary diseases was set up, the cure rates improved upto 56%. Conclusion: Acromegaly has wide-ranging manifestations from acral enlargement to altered sensorium; incidental diagnosis was not prevalent in our series. Majority of the cases were due to the presence of a pituitary macroadenoma. Better cure rates can be achieved only when a dedicated group of multidisciplinary team is involved.

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“…In a recent case, a 23 year old man who had ectopic acromegaly secondary to an incidentally discovered pheochromocytoma demonstrated improved symptoms after tumor resection, and positivity of the tumor tissue with GHRH immunostaining [79]. Rarely, ectopic acromegaly may be secondary to secretion of GH, as reported in a pancreatic islet cell tumor, a bronchial carcinoid tumor and lymphoma [7–9]. …”

Section: Published Causes Of Ectopic Acromegalymentioning

confidence: 99%

“…The incidence of acromegaly is approximately 3 cases per 1 million persons per year and the prevalence is about 60 cases per million. In less than 1% of cases acromegaly may develop because of ectopic secretion of growth hormone releasing hormone (GHRH) [1–6] or more rarely GH, from a nonpituitary origin, mostly from a neuroendocrine tumor (NET) [7–9]. In 1959 Altman and Schutz reported an acromegaly patient who did not respond to pituitary irradiation but improved markedly after surgical resection of a lung carcinoid tumor [2].…”

Section: Introductionmentioning

confidence: 99%

Ectopic acromegaly due to growth hormone releasing hormone

et al. 2012

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Acromegaly Caused by Ectopic Growth Hormone: A Rare Manifestation of a Bronchial Carcinoid

Cited by 20 publications

References 8 publications

Clinical profile and outcome of patients with acromegaly according to the 2014 consensus guidelines: Impact of a multi-disciplinary team

Clinical profile and outcome of patients with acromegaly according to the 2014 consensus guidelines: Impact of a multi-disciplinary team

Can Immediate Post-Operative Random Growth Hormone Levels Predict Long Term Cure in Patients with Acromegaly?

Ectopic acromegaly due to growth hormone releasing hormone

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