Endocrine Abstracts

Acromegaly is frequently associated with tumor development of various organs, mostly with cancer of colon and thyroid gland while the development of gastric cancer is a very rare condition.

We observed a 33-years-old woman with mild clinical signs of acromegaly. The diagnosis was confirmed by laboratory tests (increased levels of IGF1 and growth hormone – 573 ng/ml and 9.8 ng/ml respectively) and MRI (supra-infra-latero-cellary pituitary adenoma, 9×20×18 mm) (September 2006). The patient received injections of Sandostatin LAR with maximum dose 40 mg per 28 days and dopamine agonists due to low sensitivity to the drug.

During next 2 years the patient regularly underwent a complex examination. According to diagnostic tests no hormonal remission of acromegaly was reached, but the patient refused from repeatedly recommended surgery. According to next gastroendoscopy (20 April 2007) a superficial antral gastritis associated with H. Pylori was diagnosed and necessary therapy was conducted.

At the end of August 2008 the patient noticed the increase of her abdomen size and discomfort in the epigastric area. According to the ultrasound there were the pelvic ascites and signs of bilateral ovarian tumors. The diagnosis of bilateral ovarian cancer was suspected. While preparation to the surgical treatment of ovarian cancer, the gastroscopy was done: the infiltrating ulcer of gastric body and pyloric channel was revealed. According to histological results the mucinous carcinoma of the stomach was found. Thus, the tumors in the ovaries were metastases of gastric cancer. Patient refused from surgical treatment of cancer and died in two and a half months from approval of diagnosis. This case demonstrates the aggressiveness of cancer in patients with acromegaly and it needs further studies of this problem