Health-Related Complications of Acromegaly-Risk of Malignant Neoplasms.

Marek Ruchala,Kosma Wolinski

doi:10.3389/fendo.2019.00268

Abstract

The issue of increased risk of benign and malignant neoplasms in patients with acromegaly remains the topic of debate from many years and was addressed by numerous studies. Many of them have shown increase in the cancer incidence. Among particular types of malignancies, thyroid, colorectal, and breast cancer are most commonly indicated as associated with acromegaly. Single reports denoted increase in prevalence of neoplasms of other organs such as kidney, bone or central nervous system. Cardiovascular and respiratory tract disorders were traditionally consider as main causes of mortality in acromegalic patients, accounting for about 60 and 25% of deaths, respectively. However, according to a number of studies published over the current decade cancer became the most important cause of deaths. Aim of the current article was to review the literature concerning the risk of malignant neoplasms in acromegaly and its clinical implications.

Highlights

The issue of increased risk of benign and malignant neoplasms in patients with acromegaly remains the topic of debate from many years and was addressed by numerous studies
Numerous studies proved increase prevalence of malignancies in patients with acromegaly; elevated risk of thyroid, colon and breast cancer was indicated by many researches
Careful screening for malignancies should be important part of the management of acromegalic patients

Summary

INTRODUCTION

The issue of increased risk of benign and malignant neoplasms in patients with acromegaly remains the topic of debate from many years and was addressed by numerous studies. The most commonly discussed mechanism of such phenomenon is increased level of growth hormone (GH) and subsequently insulin-like growth factor 1 (IGF-1) [1]. Both normal epithelial cells and colorectal cancer cells express IGF-1 receptor (IGF-R) and can be influenced by high levels of IGF-1 [1, 2]. Despite the pathophysiological mechanisms of carcinogenesis in acromegaly seem to be well-described, the clinical importance of this findings remains the issue of debate. Our aim was to perform the narrative review of the literature concerning the risk of malignant neoplasms in acromegaly and its clinical implications

OVERALL CANCER INCIDENCE

THYROID NEOPLASMS

COLORECTAL CANCER AND POLYPS

BREAST CANCER

OTHER CANCERS

SUMMARY AND CONCLUSIONS