Endocrine Abstracts

Introduction: Only several cases of co-existing meningiomas and pituitary tumours secreting growth hormone (GH) have been described so far in patients not treated previously with irradiation.

Aim: The aim of the study was to describe two cases of co-occurrence of acromegaly and meningioma and to discuss their relationship.

Case reports: Case 1. 52-year old female complained of visual disturbances. She was diagnosed with pituitary microadenoma secreting GH, and subsequently underwent successful transsphenoidal surgery. MRI performed after surgery revealed the presence of the second tumour invading right optic nerve canal. She was re-operated, meningioma was confirmed on histopathological examination. After the surgery her visual field has improved.

Case 2. 26-year old female was admitted to the hospital due to rapidly progressing apathy and extremities paralysis. Head CT showed the giant tumour of parasellar region invading neighbouring central nervous system structures. She was operated by transcranial approach). The histopathological assessment showed fibrous meningioma. After second transsphenoidal surgery, the GH-secreting pituitary tumour was confirmed. Although the operation did not removed the whole tumour, the patient improved substantially. One year later she was re-operated because of high levels of GH not controlled by somatostatin analogue injections. Unfortunately, the surgery did not normalised GH levels. The patient declined irradiation.

Conclusions: Co-existence of meningiomas and acromegaly may result from pro-proliferative action of high levels of GH and/or IGF-1 on central nervous system tumours expressing growth hormone and insulin-like growth factors receptors, although most of the clinical observations argue against the close relationship between increased IGF-1 levels and development of meningiomas in humans.