Acromegaly and Pheochromocytoma: Report of a Rare Coexistence
| Autor: | Gina G. Sleilati, Mahalakshmi Honasoge, Kalman Kovacs |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Adenoma
medicine.medical_specialty Pathology Endocrinology Diabetes and Metabolism Urinary system Adrenal Gland Neoplasms Pheochromocytoma Growth Hormone-Releasing Hormone Gastroenterology Catecholamines Endocrinology Pituitary adenoma Internal medicine Acromegaly medicine Humans Endocrine system Pituitary Neoplasms Insulin-Like Growth Factor I Multiple endocrine neoplasia Metanephrine Human Growth Hormone business.industry General Medicine Metanephrines Middle Aged medicine.disease Magnetic Resonance Imaging Diabetes Mellitus Type 2 Hypertension Female Headaches medicine.symptom business |
| Zdroj: | Endocrine Practice. 8:54-60 |
| ISSN: | 1530-891X |
| DOI: | 10.4158/ep.8.1.54 |
| Popis: | Objective To describe a patient with the rare coexistence of acromegaly and pheochromocytoma. Methods We report a case of a 57-year-old woman, who was initially examined because of polyarthritis, she was also diagnosed with type 2 diabetes mellitus and hypertension at age 56 years. Her history, clinical findings, laboratory results, and management are summarized, and etiologic hypotheses are discussed. Results The patient had recurrent headaches and reported an increasing size of her shoes and gloves during the previous 4 years. Enlargement of her hands and feet and a bilateral temporal field defect were noted on examination. Laboratory studies revealed high levels of insulin-like growth factor I (IGF-I) and growth hormone (GH). Magnetic resonance imaging (MRI) showed a 3-cm sellar mass with impingement on the optic chiasm. The plasma level of growth hormone-releasing hormone (GHRH) was normal. She underwent transsphenoidal adenomectomy. Histologic examination confirmed a pituitary adenoma, immunoreactive for GH. Postoperatively, her headaches and arthritic pain diminished, and her levels of IGF-I and GH normalized; however, labile hypertension persisted. The urinary metanephrines and plasma catecholamines were increased. A 3-cm left adrenal mass, seen on abdominal MRI, was removed laparoscopically, after which urinary metanephrines normalized and both the diabetes and the hypertension resolved. Histopathologic analysis confirmed the diagnosis of pheochromocytoma. Immunohistochemical staining was negative for GHRH. Conclusion The finding of a pheochromocytoma and acromegaly could be a fortuitous coexistence of two separate endocrine tumors; however, the probability of such an event is extremely low. A cause-and-effect relationship has been suggested because of previous reports of GHRH production by pheochromocytomas. Some investigators have also suggested that this coexistence might be a multiple endocrine neoplasia variant. Our patient had no evidence of GHRH production, nor did we document any familial autosomal dominant transmission pattern. (Endocr Pract. 2002;8:54-60) |
| Databáze: | OpenAIRE |
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