Endocrine Abstracts

Introduction: Although it has been suggested that there is a strong association between acromegaly and premalignant colonic lesions and colon cancer, it seems that in real – life practice the adherence to ACRO colonoscopy guidelines might be lower than expected (as recently shown by M.Parolin et cols).

Methods: We retrospectively reviewed the case records of the 54 patients with acromegaly seen in our center since 1994.We analyzed the findings of 27 patients who had undergone full length colonoscopy.

Results: Only 50% of our patients underwent at least one colonoscopy. 34 colonoscopies were performed since 1994 and the total number of colonoscopies increased from 0 in the period of 1994–1999, to 9 in the period of 2000–2005, and to 21 between 2012 to 2017.25% of the colonoscopies were performed at diagnosis and 75% during follow up. Diverticulosis and internal hemorroids were the most frecuent findings. In 33% of the screened patients (9/27) polyps were found. Among these patients 7 were women and 2 were men with a median age of 60.5 years (42–79) and a median IGFI level of 343,4 (126–761). A total of 18 polyps were found with a median size of 5 mm (2–11 mm), and the adenomatous polyps being the most frequent type. Pathological specimen results were Hyperplastic polyp (5/18), tubular adenoma (10/18), tubulovillous adenoma (1/18), villous adenoma(1/18), serrated adenoma (1/18). 1 female patient had colon adenocarcinoma (3.7%, 1/27). No complications related to the endoscopic examination were reported, such as perforation or bleeding.

Conclusions: The compliance to the guidelines in our center has been low with an increasing adhesion over the years. We do not know the reasons behind this change, but we are aware that due to the findings in our series, we will work towards a more proactive surveillance and improve the adherence to the guidelines.