Endocrine Abstracts

GH replacement is widely used in adults with hypopituitarism, but its effect on tumor occurrence and pituitary tumor recurrence is unknown. Furthermore, in literature there are scant with short follow-up time. The available data do not seem to suggest that rhGH replacement increased the incidence of regrowth of pituitary tumor and of cancer in adults with GHD, provided that IGF1 concentrations remain within the normal range for age.

The aim of our study was to evaluate the tumor occurrence and pituitary tumor recurrence in 84 adult patients with GHD (42 females, 42 males; range 16–75; 11 CO, 73 AO), admitted at our Department from 1995 to 2002 with the following diagnoses: 48 adenomas (34 clinically functionless pituitary tumors, 3 corticotropinomas, 9 prolactinomas, 2 somatotropinomas), 16 craniopharingiomas, 1 dysgerminoma, 1 arachnoid cyst, 1 tumor gigantocellular, 17 idiopathic GHD. Diagnosis of GHD was performed after 6–12 months of the treatment for primary disease. All GHD patients were replaced with rhGH.

New tumors were reported in 2 (2.4%) patients during rhGH replacement (one colon carcinoma was diagnosed in a patients after 3 years, one breast carcinoma was diagnosed in another patient after 5 years). In 2 patients the occurrence of new tumor was found after the cessation of rhGH replacement (one uterus carcinoma and one hepatocarcinoma after 4 year of rhGH discontinuation). Recurrence of pituitary tumors was reported in 8 (12.5%) patients: 4 (8.3%) pituitary adenomas and 4 (25%) craniopharyngiomas.

In conclusion, the recurrence rate of pituitary tumor and occurrence of new tumors in our population do not appear to be increased compared with published data. However, longer follow-up regarding recurrences and secondary neoplasms remains essential.