Endocrine Abstracts

Introduction: Acromegaly is a chronic disease caused by excessive secretion of growth hormone (GH), and as a result, of insulin-like growth factor-1 (IGF1). Although controversial, frequency of both benign and malignant neoplasm formation is thought to be increased in acromegalic patients. Pleomorphic adenoma is the most common arising tumour from the parotid salivary gland. Here we report the case of a 33-year-old woman with acromegaly and also who presented with a swelling on the left neck and diagnosed as pleomorphic adenoma arising from parotid gland after excision of the tumour.

Case report: 33-year-old woman admitted to the hospital complaining of a 2-week history of visual loss and headache. She also determined weight gain, menstrual irregularity, libido loss, galactorrhoea, and a slowly growing swelling on the left neck during the last year. Hypophyseal MRI revealed a mass of 20×32 mm occupying the sellae and invasing right cavernous sisternae and extending to the optic chiasm. Hormonal evaluation demonstrated that the patient had acromegaly and secondary hypothyroidism. Parotid ultrasound (US) revealed a 42×28×45 mm heterogenous, hypoechoic intraglandular lobulated solid mass occupying left parotid gland superficial lobe and extending to the deep lobe. Hypohpyseal adenoma was excised by transsphenoidal route and immunohistochemical analysis showed extensive GH positivity. She had residual tumour after the operation and somatostatin analogous therapy was started in the follow-up period. After eight months from the hypophyseal operation the parotid tumour was excised and pathology showed that it was a pleomorphic adenoma.

Conclusion: It seems that this is the first case of a coincidence between an acromegaly and pleomorphic adenoma of parotid gland in the English literature. We don’t have still enough knowledge about an association between salivary gland tumours and acromegaly. If present or not this association must be evaluated with the further studies.