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open access

Vol 70, No 2 (2019)
Case report
Submitted: 2018-12-11
Accepted: 2018-12-23
Published online: 2019-02-11
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Acromegaly associated with GIST, non-small cell lung carcinoma, clear cell renal carcinoma, multiple myeloma, medulla oblongata tumour, adrenal adenoma, and follicular thyroid nodules

Aleksandra Jawiarczyk-Przybyłowska1, Beata Wojtczak2, James Whitworth3, Krzysztof Sutkowski2, Martin Bidlingmaier4, Márta Korbonits5, Marek Bolanowski1
DOI: 10.5603/EP.a2019.0005
·
Pubmed: 30742299
·
Endokrynol Pol 2019;70(2):213-217.
Affiliations
  1. Department of Endocrinology, Diabetes, and Isotope Therapy, Medical University Wroclaw, Wrocław, Poland
  2. Department of Endocrinological Surgery, Medical University Wroclaw, Wrocław, Poland
  3. Department of Medical Genetics, University of Cambridge Cancer Research UK Cambridge Centre, Cambridge, United Kingdom
  4. Endocrine Laboratory, Ludwig-Maximilians-University of Munich, Munich, Germany
  5. Centre for Endocrinology, Barts and the London School of Medicine, Queen Mary University of London, London, United Kingdom

open access

Vol 70, No 2 (2019)
Case report
Submitted: 2018-12-11
Accepted: 2018-12-23
Published online: 2019-02-11

Abstract

Acromegaly is associated with increased growth hormone (GH) and insulin-like growth factor-I (IGF-I) secretion which may support tumour development and growth. A 68-year-old woman was diagnosed with acromegaly due to typical clinical and hormonal characteristics. While contrast-enhanced MRI at diagnosis did not reveal a pituitary adenoma, a 5-mm lesion was identified on repeat scanning 13 months later. Abdominal and chest CT showed tumours of the stomach, right adrenal gland, and right lung. The CT also showed a hypodense lesion in the liver and heterogeneous echostructure of the thyroid gland with left lobe solid-cystic tumour. Somatostatin receptor scintigraphy revealed increased tracer accumulation in the right thyroid lobe. No tracer accumulation was noted at the location of the other tumours. The resected stomach, adrenal, chest, and thyroid lesions did not show GH secretion. The patient refused pituitary surgery, and her acromegaly is currently well-controlled with somatostatin analogue therapy. A CT scan 19 months later revealed a contrast-enhancing left kidney tumour that was a G1-grade clear cell carcinoma. Four years after the acromegaly diagnosis multiple myeloma were diagnosed with secondary renal amyloidosis. Genetic screening for a paraganglioma gene panel, AIP, MEN1, and CDKN1B mutations were negative. A next-generation cancer panel containing 94 cancer genes did not identify any possible unifying gene abnormality in her germline DNA. Coexistence of acromegaly and numerous other tumours suggests a common aetiology of these disorders. However, no genetic abnormality could be identified with the tests that have been performed. 

Abstract

Acromegaly is associated with increased growth hormone (GH) and insulin-like growth factor-I (IGF-I) secretion which may support tumour development and growth. A 68-year-old woman was diagnosed with acromegaly due to typical clinical and hormonal characteristics. While contrast-enhanced MRI at diagnosis did not reveal a pituitary adenoma, a 5-mm lesion was identified on repeat scanning 13 months later. Abdominal and chest CT showed tumours of the stomach, right adrenal gland, and right lung. The CT also showed a hypodense lesion in the liver and heterogeneous echostructure of the thyroid gland with left lobe solid-cystic tumour. Somatostatin receptor scintigraphy revealed increased tracer accumulation in the right thyroid lobe. No tracer accumulation was noted at the location of the other tumours. The resected stomach, adrenal, chest, and thyroid lesions did not show GH secretion. The patient refused pituitary surgery, and her acromegaly is currently well-controlled with somatostatin analogue therapy. A CT scan 19 months later revealed a contrast-enhancing left kidney tumour that was a G1-grade clear cell carcinoma. Four years after the acromegaly diagnosis multiple myeloma were diagnosed with secondary renal amyloidosis. Genetic screening for a paraganglioma gene panel, AIP, MEN1, and CDKN1B mutations were negative. A next-generation cancer panel containing 94 cancer genes did not identify any possible unifying gene abnormality in her germline DNA. Coexistence of acromegaly and numerous other tumours suggests a common aetiology of these disorders. However, no genetic abnormality could be identified with the tests that have been performed. 

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Keywords

patient; acromegaly; multiple tumours; genetics

About this article
Title

Acromegaly associated with GIST, non-small cell lung carcinoma, clear cell renal carcinoma, multiple myeloma, medulla oblongata tumour, adrenal adenoma, and follicular thyroid nodules

Journal

Endokrynologia Polska

Issue

Vol 70, No 2 (2019)

Article type

Case report

Pages

213-217

Published online

2019-02-11

Page views

2688

Article views/downloads

1477

DOI

10.5603/EP.a2019.0005

Pubmed

30742299

Bibliographic record

Endokrynol Pol 2019;70(2):213-217.

Keywords

patient
acromegaly
multiple tumours
genetics

Authors

Aleksandra Jawiarczyk-Przybyłowska
Beata Wojtczak
James Whitworth
Krzysztof Sutkowski
Martin Bidlingmaier
Márta Korbonits
Marek Bolanowski

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