Journal List > J Korean Soc Endocrinol > v.20(4) > 1063808

TOOLS
Nam, Kim, Kong, Kim, Park, Park, Ahn, Lee, Cha, Lim, Kim, and Lee: A Case of Acromegaly with Gall Bladder Cancer
Case Report
Journal of Korean Society of Endocrinology

Journal of Korean Society of Endocrinology 2005; 20(4): 401-406.

Published online: 31 August 2005

DOI: https://doi.org/10.3803/jkes.2005.20.4.401

A Case of Acromegaly with Gall Bladder Cancer

Ji Sun Nam, Chul Sik Kim, Jee Hyun Kong, Hai Jin Kim, Jin A Park, Jong Suk Park, Chul Woo Ahn, Se Joon Lee, Bong Soo Cha, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee

Department of Internal Medicine, Yonsei University College of Medicine, Korea.

Received 31 March 2005       Accepted 4 July 2005

Copyright © 2005 Korean Endocrine Society

Abstract

Acromegaly is a systemic endocrine disorder due to an excessive release of growth hormone, which increases the serum levels of insulin-like growth factor-1 (IGF-1). Elevated levels of these hormones are assumed to increase the incidence of malignant tumors in patients with acromegaly, due to by stimulating the growth and maturation of cells. In particular, IGF-1 is considered to be closely related with the development of colon polyps and colon cancers. Studies suggest that various malignant tumors, including thyroid cancer, brain tumor and renal cell carcinomas, are also more common in patients with acromegaly. Here, a case of gall bladder cancer in a patient with acromegaly, and the possible relationships between these two disorders, is reported.

Keywords: Acromegaly, Gall bladder cancer, Growth hormone, Insulin-like growth factor-1

Figures and Tables

Fig. 1
Acral bony overgrowth results in increased hand and foot size, and prognathism; soft tissue swelling results in coarse facial features and large fleshy nose.
jkse-20-401-g001
Fig. 2
Sella MRI: There is a 3.2×2.5 cm sized, heterogeneously enhancing, irregular mass lesion. It extends into suprasella lesion and invasively extends into right side carvenous sinus, while encircling right carotid artery
jkse-20-401-g002
Fig. 3
Abdominal CT
3A. 5 cm sized soft tissue mass lesion on GB with extensive localized invasion, metastatic lymphadenopathy, and peritoneal carcinomatosis
3B. More enlarged primary mass lesion measuring 7.5 cm with more advanced peritoneal carcinomatosis after 2 cycles of chemotherapy
jkse-20-401-g003
Fig. 4
Cholangiogram
4A. Bilateral intrahepatic duct dilatation on hilar level
4B. Left-to-right anterior and right posterior-to-common bile duct metallic biliary stent inserted state
jkse-20-401-g004

References

1. Colao A, Ferone D, Marzullo P, Lombardi G. Systemic complications of acromegaly: epidemiology, pathogenesis, and management. Endocr Rev. 2004. 25:102–152.
2. Baris D, Gridley G, Ron E, Weiderpass E, Mellemkjaer L, Ekbom A, Olsen JH, Baron JA, Fraumeni JF Jr. Acromegaly and cancer risk, A cohort study in Sweden and Denmark. Cancer Cause Control. 2002. 13:395–400.
3. Pierre M. Sur deux cas d'acromegalie. Hypertrophe singluliere no congenitale des extremites superieures, inferieures et cephalique. Rev Med Fran. 1886. 6:297–333.
4. Wass JA. Growth hormone, insulin-like growth factor-I and its binding proteins in the follow-up of acromegaly. J Endocrinol. 1997. 155:S17–S19.
5. Jenkins PJ, Besser M. Clinical perspective: acromegaly and cancer: a problem. J Clin Endocrinol Metab. 2001. 86:2935–2941.
6. Webb SM, Casanueva F, Wass JA. Oncological complications of excess GH in acromegaly. Pituitary. 2002. 5:21–25.
7. Orme SM, McNally RJ, Cartwright R, Belchetz PE. Mortality and cancer incidence in acromegaly: a retrospective cohort study. J Clin Endocrinol Metab. 1998. 83:2730–2934.
8. Lin B, Kinoshita Y, Hato F, Tsuji Y. Enhancement of DNA synthetic activity of thymic lymphocytes by the culture supernatant of thymic epithelial cells stimulated by growth hormone. Cell Mol Biol. 1997. 43:351–359.
9. LeRoith D, Baserga R, Helman L, Roberts C. Insulin-like growth factors and cancer. Ann Intern Med. 1995. 122:54–59.
10. Yamaguchie M, Tate G, Yoshizawa Y, Midorikawa T, Sanada Y, Kumada K. Hepatocellular carcinoma in a patient with acromegaly and high serum levels of insulin-like growth factor I: report of a case. Surg Today. 2002. 32:1008–1011.
11. Moon HD, Simpson ME, Li CH, Evans HM. Neoplasia in rats treated with pituitary growth hormone I, pulmonary and lymphatic tissues. Cancer Res. 1950. 14:297–308.
12. Resnicoff M, Li W, Basak S, Herlyn D, Baserga R, Rubin R. Inhibition of rat C6 glioblastoma tumor growth by expression of insulin-like growth factor-1 receptor antisense mRNA. Cancer Immunol Immunother. 1996. 42:64–68.
13. Melmed S. Acromegaly and cancer: not a problem? J Clin Endocrinol Metab. 2001. 86:2929–2934.
14. Jenkins PJ, Bustin SA. Evidence for a link between IGF-I and cancer. European J Endocrinol. 2004. 151:S17–S22.
15. Sell C, Dumenil G, Deveaud C, Miura M, Coppola D, DeAngelis T, Rubin R, Efstratiadis A, Baserga R. Effect of a null mutation of the type 1 IGF receptor gene on growth and transformation of mouse embryo fibroblasts. Mol Cell Biol. 1994. 14:3604–3612.
16. Sell C, Rubini M, Rubin R, Liu JP, Efstratiadis A, Baserga R. Simian virus 40 large tumor antigen is unable to transform mouse embryonic fibroblasts lacking type-1 insulin-like growth factor receptor. Proc Natl Acad Sci USA. 1993. 90:11217–11221.
17. Mauro L, Surmacz E. IGF-1 receptor, cell-cell adhesion, tumour development and progression. J Mol Histol. 2004. 35:247–253.
18. Baris M, Gridley G, Ron E, Weiderpass E, Mellemkhaer L, Ekbom A, Olser JH, Baron JA, Fraumeni JF Jr. Acromegaly and cancer risk: a cohort study in Sweden and Denmark. Cancer Cause Control. 2002. 13:395–400.
19. Klein I, Parveen G, Gavaler JS, Vanthiel DH. Colonic polyps in patients with acromegaly. Ann Intern Med. 1982. 97:27–30.
20. Balkany C, Cushing GW. An association between acromegaly and thyroid carcinoma. Thyroid. 1995. 5:47–50.
21. Cheung NW, Boyages SC. Increased incidence of neoplasia in females with acromegaly. Clin Endocrinol (Oxf). 1997. 47:323–327.
TOOLS
Similar articles