ECE2017 Eposter Presentations: Pituitary and Neuroendocrinology Neuroendocrinology (33 abstracts)
Santa Maria Hospital, Lisbon, Portugal.
Introduction: Acromegaly is a rare disease resulting from pathological oversecretion of growth hormone (GH) and insulin-like growth factor-1 (IGF-1). The clinical spectrum includes cardiovascular and respiratory diseases but also increased risk of benign and malignant neoplasms.
Objectives: Evaluate the prevalence of cancer and seek for associated factors in acromegaly.
Methods: Retrospective study of 94 patients with acromegaly treated in a single tertiary center from 1985 to 2016. The group with malignant neoplasms was compared with the group without malignancy. Statistical analysis was performed with SPSS software, version 20. Statistical significance: P < 0.05.
Results: 63.8% of the patients were female and the mean age at diagnosis was 48.7±12.9 years. Median GH and mean IGF-1 at diagnosis was 9.8 ng/ml (range: 0.61228) and 857.4±412.7 ng/ml, respectively. Median diagnostic delay of acromegaly was 7 years (range: 136). Cancer was present in 13 (13.8%) of the 94 patients. Colon cancer was diagnosed in five patients (5.3%), breast cancer and renal cell carcinoma each in 3 (3.2%), follicular thyroid cancer, melanoma and endometrial carcinoma each in 1 (1.1%). In three cases, cancer was found before acromegaly (breast cancer in 2 and colon cancer in 1). One patient had two malignancies (thyroid and renal cell carcinoma). The diagnostic delay of acromegaly was higher in the group with malignant neoplasm (P=0.004). There was no statistically significant difference between the two groups relative to GH, IGF-1, age and body mass index at diagnosis and gender.
Conclusions: Colon cancer was the most prevalent, followed by breast and renal carcinoma. In the group with malignant neoplasms, diagnostic delay was significantly higher, suggesting that prolonged exposure to high GH and IGF-1 levels can be related to cancer development. Search for cancer should be a major task in the follow-up of these patients.