Increased incidence of neoplasia in patients with pituitary adenomas

Popović, Vera; Damjanović, Svetozar; Micić, Dragan; Nesović, M; Djurović, Marina; Petakov, Мilan; Obradović, S.; Zorić, Svetlana; Simic, Mirjana; Penezić, Zvjezdan; Marinković, Jelena; Group, The Pituitary Study

doi:10.1046/j.1365-2265.1998.00536.x

Cited by 183 publications

(113 citation statements)

References 33 publications

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“…With the improvement in the management of acromegaly, more patients will reach ages at which cancer incidence increases, and it will be important in the future to compare results from acromegalic patients with those of age-matched populations. Colorectal cancer has been reported in about 1% of acromegalic patients, and prevalence in our population was similar (1.2%), as also were the prevalences of breast cancer (3.1%) and bronchial cancer (0.4%) (35)(36)(37)(38). Colonoscopic examinations were not carried out systematically in all patients in this observational registry, which explains the low prevalence of colon polyps identified (9.5%), in comparison with studies in which all patients underwent pancolonoscopy prospectively (9 -40%) (32).…”

Section: Morbiditymentioning

confidence: 72%

Epidemiology, clinical characteristics, outcome, morbidity and mortality in acromegaly based on the Spanish Acromegaly Registry (Registro Espanol de Acromegalia, REA)

Mestrón

Webb

Astorga

et al. 2004

European Journal of Endocrinology

351

232

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Objective: To undertake a multicentre epidemiological study reflecting acromegaly in Spain. Design: Voluntary reporting of data on patients with acromegaly to an online database, by the managing physician. Methods: Data on demographics, diagnosis, estimated date of initial symptoms and diagnosis, pituitary imaging, visual fields, GH and IGF-I concentrations (requested locally), medical, radiotherapy and neurosurgical treatments, morbidity and mortality were collected. Results: Data were included for 1219 patients (60.8% women) with a mean age at diagnosis of 45 years (S.D. 14 years). Reporting was maximal in 1997 (2.1 cases per million inhabitants (c.p.m.) per year); prevalence was globally 36 c.p.m., but varied between 15.7 and 75.8 c.p.m. in different regions. Of 1196 pituitary tumours, most were macroadenomas (73%); 81% of these patients underwent surgery, 45% received radiotherapy and 65% were given medical treatment (somatostatin analogues in 68.3% and dopamine agonists in 31.4%). Cures (GH values (basal or after an oral glucose tolerance test) , 2 ng/ml, normal IGF-I, or both) were observed in 40.3% after surgery and 28.2% after radiotherapy. Hypertension (39.1%), diabetes mellitus (37.6%), hypopituitarism (25.7%), goitre (22.4%), carpal tunnel syndrome (18.7%) and sleep apnoea (13.2%) were reported as most frequent morbidities; 6.8% of the patients had cancer (breast in 3.1% of the women and colon in 1.2% of the cohort). Fifty-six patients died at a mean age of 60 years (S.D. 14 years), most commonly of a cardiovascular cause (39.4%); mortality was greater in patients given radiotherapy (hazard ratio 2.29; 95% confidence interval 1.03 to 5.08; P ¼ 0.026), and in those in whom GH and IGF-I concentrations were never normal (P , 0.001). Conclusions: This acromegaly registry offers a realistic overview of the epidemiological characteristics, treatment outcome and morbidity of acromegaly in Spain. As active disease and treatment with radiotherapy are associated with an increase in mortality, efforts to control the disease early are desirable.

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Section: Morbiditymentioning

confidence: 72%

Epidemiology, clinical characteristics, outcome, morbidity and mortality in acromegaly based on the Spanish Acromegaly Registry (Registro Espanol de Acromegalia, REA)

Mestrón

Webb

Astorga

et al. 2004

European Journal of Endocrinology

351

232

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“…Some studies have shown a higher frequency of differentiated thyroid carcinomas in acromegalic patients (16,21,22) due to the increased level of GH and IGF-I. Calculated risk of thyroid cancer in these patients appears to be sixty-fold higher than in the overall population (23,24).…”

Section: Discussionmentioning

confidence: 99%

Frequency of various types of neoplasia in a group of acromegalic patients

Bolfi

Miot

Resende

et al. 2013

Arq Bras Endocrinol Metab

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Objective: To determine the frequency of colon cancer, primary hyperparathyroidism, thyroid tumor, and skin cancer in all acromegalic patients in follow-up at the Clinics Hospital -Botucatu Medical School, from 2005 to 2011. Subjects and methods: These patients were evaluated retrospectively for colon cancer, primary hyperparathyroidism, dermatological, and thyroid tumors. Results: Of 29 patients included at the beginning of the study, two were excluded. Among 19 patients submitted to colonoscopy, one presented colon adenocarcinoma (5%). Thyroid nodules were present in 63% of patients, and papilliferous carcinoma was confirmed in two patients (7,7%). Four patients were confirmed as having primary hyperparathyroidism (15%). The most common dermatologic lesions were thickened skin (100%), acrochordons (64%), epidermal cysts (50%), and pseudo-acanthosis nigricans Dentre os 19 pacientes submetidos à colonoscopia, um apresentou adenocarcinoma de cólon (5%). Nódulos de tireoide estiveram presentes em 65% dos pacientes e carcinoma papilífero, em dois deles (7,7%). Quatro pacientes apresentaram hiperparatireoidismo primário (15%). A maioria das lesões de pele foram: espessamento (100%), acrochordons (64%), cistos epidérmicos (50%), pseudoacantose nigricans (50%) e apenas um paciente apresentou carcinoma basocelular. Conclusão: O tamanho da amostra é pequeno, mas nossos achados confirmam a alta frequência da neoplasia da tireoide e hiperparatireroidismo neste grupo de pacientes. Arq Bras Endocrinol Metab. 2013;57(8):612-6 Descritores

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“…Bates et al observed an increased mortality from malignancies in hypopituitary women (44), whereas the risk of death in a malignant disease was unaffected in the prospective study by Tomlinson et al (47). In the retrospective study by Popovic et al, the rate of neoplasia in non-functional and GH-producing pituitary adenoma was compared with that in the general population (85). They found increased frequency of cancer both in patients with non-functional pituitary adenoma and in acromegalic patients as compared with the expected incidence in the general population (85).…”

Section: Risk Of Malignant Diseasementioning

confidence: 99%

Safety aspects of GH replacement

Svensson¹,

Bengtsson²

2009

European Journal of Endocrinology

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In adults, GH replacement therapy will often be maintained for decades. Owing to the long duration of GH replacement in many adults, it is essential to establish the long-term safety aspects of the treatment. In this review, studies that have investigated the safety profile of long-term GH replacement will be reviewed with an emphasis on studies based on data from the Pfizer International Metabolic Database (KIMS). These studies show that long-term GH replacement in adults is safe and that long-term GH replacement may even improve cardiovascular mortality and morbidity in GH-deficient adults.

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Increased incidence of neoplasia in patients with pituitary adenomas

Abstract: We have demonstrated that the overall incidence of malignant tumours in patients with non-functioning pituitary adenomas and acromegaly is significantly higher than expected for general population and for our internal control group.

Cited by 183 publications

References 33 publications

Epidemiology, clinical characteristics, outcome, morbidity and mortality in acromegaly based on the Spanish Acromegaly Registry (Registro Espanol de Acromegalia, REA)

Epidemiology, clinical characteristics, outcome, morbidity and mortality in acromegaly based on the Spanish Acromegaly Registry (Registro Espanol de Acromegalia, REA)

Frequency of various types of neoplasia in a group of acromegalic patients

Safety aspects of GH replacement

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