Vol 57, No 1 (2006)
Case report
Published online: 2006-03-20
Five year remission of GHRH secreting bronchial neuroendocrine tumor with symptoms of acromegaly. Utility of chromogranin A in the monitoring of the disease
Endokrynol Pol 2006;57(1):32-36.
Abstract
Acromegaly is usually caused by excess GH (growth hormone)
secretion by pituitary adenoma. Extremely rare (< 1%
of cases) acromegaly can be a result of ectopic GHRH
(growth hormone releasing hormone) secretion by bronchial
tubes, lung, pancreatic or intestinal tumor. The aim of this
description is to present the case of successfully treated
acromegaly caused by ectopic GHRH secretion by bronchial
neuroendocrine tumor and the usefulness of chromogranin
A assay in the disease monitoring. The diagnosis
of acromegaly in 61-year old woman was based on typical
clinical picture and elevated GH and IGF-1(insulin-like growth factor-1) levels. MRI (magnetic resonance imaging)
images revealed no tumor in the pituitary but only the pituitary
enlargement. Moreover, the right lung tumor (10 cm
size) and elevated GHRH level were documented. The secretion
of GH, IGF-1 and GHRH were normalized and
progression of acromegaly was stopped after the carcinoid
tumor surgery. Currently, 5 year after surgery, acromegaly is still in the remission, as the normal levels of GH,
IGF-1, chromogranin A and normal chest and pituitary
images confirm. The authors emphasize usefulness of
measurement of chromogranin A concentration for the
evaluation of the tumor remission in case the routine
GHRH assay is not accessible.
Keywords: acromegalyectopic GHRHneuroendocrine tumorchromogranin A
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