A rare case with incidental coexistence of acromegaly and pancreatic adenocarcinoma; Case report

Abstract

Acromegaly is a rare endocrine disease. Acromegalyis associated with an increased prevalence of colorectal cancer and pre-malignant tubularadenomas, and also may be associated with other organ malignancies such as breast and thyroid. In this article, were reported rare case in th elight of coexistence of acromegaly and incidental pancreatic adenocarcinoma. A52-year-old man who was diagnosed with acromegaly about two years ago.After diagnosis, transsphenoidal surgery was performed. After surgery serum growth hormone (GH) and insulin-like growth factor 1 (IGF-1) levels was not return to normal, therefore somatostatin analog treatment was started. After this treatment, serum IGF-1 concentration was normal for age and gender. He was admitted to out-patient clinic with abdominal pain3 month ago. 44x26 mm mass lesion in the tail of the pancreas and multiple metastatic lesions in the liver were detected on abdomen computed tomography (CT). Erosive gastritis and polyps in the colon were observed on upper gastrointestinal endoscopy and colonoscopy, respectively. Endoscopic ultrasound-guided fineneedle aspiration biopsy was performed to the mass lesions in the tail of the pancreas. Pathological examination was consistent with ductal adenocarcinoma arising from the pancreas. The patients with acromegaly have an increased risk of benign and malignant neoplasms, these situation may be related with increased circulating levels of IGF-1. IGF-1 have proliferative and anti-apoptotic activity. The coexistence of acromegaly and metastatic pancreatic tumor was present in the literature but it is quite rare. It is necessary to consider that pancreatic adenocarcinoma and other malignant diseases may present in acromegaly patients.