Endocrine Abstracts

Background: Acromegaly, a chronic disease caused by excess secretion of growth hormone (GH), has been known to reduce patients life expectancy. This increase in morbility and mortality is not only due to cardiovascular, respiratory or cerebrovascular disorders, but also to an increased risk for cancer.

Subjects and methods: The aim of this study was to describe the associated malignant diseases among our fifty acromegalic patients. Clinical features of these patients (age, gender, smoking status, Diabetes and Hypertension prevalence) were recorded, as well as relevant details concerning acromegaly (ethiology, mean age of diagnosis, therapy and metabolic control of disease). The associated neoplasm and its relation with the onset of acromegaly was also analysed.

Results: Seven (3 men, 4 women; mean age: 67±12.5 year) of a total of fifty patients with acromegaly (19 men, 31 women; mean age: 56.2±16.4 year) had a malignant disease. None of the seven were active smokers, two suffered from diabetes and four from HTA. Their mean age diagnosis of acromegaly was 62.3±12.8 year with a mean duration of acromegalic disease of 4.6±4.7 year. They had been treated with transsphenoidal surgery for their GH secreting pituitary macroadenoma and active acromegaly was found on 6 of them. Colorectal, breast and thyroid carcinoma were each observed on two different patients whereas prostatic carcinoma was recorded on one. These diseases appeared before acromegaly in five patients and during its follow-up on two.

Conclusions: In our acromegalic series, 14% have a second malignant disease with a higher prevalence of colorectal, breast and thyroid neoplasm. The first two agree with what has been reported in literature, whereas the association between thyroid carcinoma and acromegaly is still to be discussed. Large-scale studies are needed to draw conclusions relating to cancer risk.