Endocrine Abstracts

Introduction: There is circumstantial evidence supporting a role of growth hormone and insulin-like growth factor 1 in the development and progression of tumors. Endosalpingiosis is characterized by the presence of non-neoplastic fallopion tube-like epithelium in ectopic anatomical locations.

Case report: A 45-year-old woman presented with a constant moderate to intense perianal pain limiting basic daily life activities. She also complained about pain at right posterior superior iliac spine area that worsened with body movements. There was no history of trauma and inspection of the area and rectal examination were normal. Her past medical history was significant for acromegaly diagnosed 4-year earlier and confirmed by anatomopathological analysis of a pituitary macroadenoma removed by transsphenoidal surgery. She had history of hyperplastic polyposis of the rectum but further investigation with colonoscopy showed no apparent mucosal lesions. Pelvic CT revealed a poorly delimitated nodular soft tissues densification in the right ischiorectal fossa of indeterminate nature. Pelvic MRI showed a spiculated soft tissue mass involving the lateral planes of the levator ani muscle and the internal obturator muscle, conditioning obliteration of the fat planes around the sciatic nerve. Given the surgical risks inherent to resection of the lesion, CT-guided biopsy was performed and the histological examination was compatible with endosalpingiosis. Since the benign nature of the lesion, medical treatment with an oral contraceptive was chosen.

Conclusions: Acromegaly appears to be associated with an increased risk of benign and malignant tumors. This case reports an unusual association between acromegaly and endosalpingiosis. Surveillance of signs and symptoms in acromegalic patients as well as adequate screening for possible comorbidities is crucial to allow timely diagnosis, clinical differential diagnosis and appropriate treatment of future lesions.