Acromegaly Secondary to Growth Hormone-releasing Hormone Secreted by an Incidentally Discovered Pheochromocytoma

Overview

Journal Endocr Pathol

Specialties Endocrinology
Pathology

Date 2007 Jul 27

PMID 17652801

Citations 13

Authors

L Vieira Neto

G F Taboada

L L Correa

J Polo

A F Nascimento

L Chimelli

K Rumilla

M R Gadelha

Affiliations

Soon will be listed here.

Abstract

Ectopic growth hormone-releasing hormone (GHRH)-secreting tumors are rare and cause acromegaly with somatotroph hyperplasia. We report a case of acromegaly secondary to GHRH secretion by an incidentally discovered pheochromocytoma in a normotensive patient. A 23-year-old man presented with signs and symptoms of acromegaly. Laboratory evaluation confirmed the diagnosis and magnetic resonance imaging (MRI) revealed a sellar mass which was thought to be a macroadenoma and surgically resected. The patient was not cured and medical treatment was indicated. An abdominal ultrasound performed before initiation of medical treatment showed a solid/cystic lesion superiorly to the right kidney. An abdominal MRI confirmed an adrenal tumor. Hormonal workup of the adrenal incidentaloma revealed elevated urinary catecholamine and total metanephrines findings strongly suggestive of a pheochromocytoma. Acromegaly was then suspected to be due to ectopic secretion of GHRH by the tumor. Patient underwent surgical resection and histopathologic examination confirmed a pheochromocytoma which stained positively for GHRH. Also, review of the pituitary specimen confirmed somatotrophic hyperplasia. Genetic analysis of the ret proto-oncogene showed no mutation. Pituitary MRI was repeated 10 months after pheochromocytoma resection and revealed a slightly enlarged pituitary and partial empty sella. The diagnosis of acromegaly caused by ectopic production of GHRH is a challenging task. A careful histopathological examination of the surgically excised pituitary tissue has a key role to arouse the suspicion and guide the investigation of a secondary cause of acromegaly.

Citing Articles

Acromegaly Caused by Ectopic Growth Hormone Releasing Hormone Secretion: A Review.

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Ockham's Razor for a Retinal Lesion and Acromegaly and Breaking the Vicious Circle.

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GHRH secretion from a pancreatic neuroendocrine tumor causing gigantism in a patient with MEN1.

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Genetics of Acromegaly and Gigantism.

Boguslawska A, Korbonits M J Clin Med. 2021; 10(7).

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Identification of a TMEM127 variant in a patient with paraganglioma and acromegaly.

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