Endocrine Abstracts

Background and aim: Acromegaly is a rare endocrine disease and is associated with an increased prevalence of colorectal cancer and pre-malignant tubular adenomas, and also may be associated with other organ malignancies such as breast and thyroid. We report a rare case of acromegaly concomitant with adenocarcinoma arising from pancreas.

Case report: A 52-year-old man who was diagnosed with acromegaly two years ago referred our outpatient clinic. After diagnosis, transsphenoidal surgery was performed. Surgery was not reduced serum growht hormone (GH) and insulin-like growth factor 1 (IGF-1) to normal, therefore somatostatin analog treatment was started. After this treatment, glucose-suppressed GH concentration was <1.0 ng/ml and serum IGF-1 concentration normal for age and gender. He was admitted to out-patient clinic with abdominal pain about 1 month ago. Abdomen CT showed that 44X26 mm mm mass lesion in the body and tail of the pancreas and multiple metastatic lesions in the liver. Upper gastrointestinal endoscopy and colonoscopy showed that erosive gastritis and polyps in the colon, respectively. After these imaging studies, endoscopic ultrasound-guided needle aspiration biopsy was performed to the mass lesions in the tail of the pancreas. Pathological examination revealed a adenocarcinoma arising from the pancreas.

Conclusions: The patients with acromegaly have an increased risk of benign and malignant neoplasms, These situation may be related with increased circulating levels of IGF-1 because of proliferative and anti-apoptotic activity of IGF-1.It is important to consider pancreatic adenocarcinoma in the presence of acromegaly.