ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2008) 16 P456

Use of videocapsule endoscopy (VCE) for the detection of small bowel tumors in patients with acromegaly

Francesca Coletti1, Cristina Lucia Ronchi3, Laura Montefusco1, Edoardo Fesce2, Cristina Ogliari2, Emanuele Ferrante3, Paolo Epaminonda1, Alessia Dolci1, Guido Adda1, Paolo Beck-Peccoz3 & Maura Arosio1

1Endocrine and Diabetic Unit, Department of Medical Sciences, San Giuseppe-MilanoCuore Hospital, University of Milan, Milan, Italy; 2Gastroenterology Unit, San Giuseppe-MilanoCuore Hospital, AFaR, Milan, Italy; 3Endocrine and Diabetic Unit, Department of Medical Sciences, Fondazione Policlinico, Mangiagalli and Regina Elena Hospital, University of Milan, IRCCS, Milan, Italy.

A high risk for small bowel (SB) tumors in acromegalic population has been reported in a cohort study (Baris D, 2002). SB lesions may be easily investigated by the recently developed videocapsule endoscopy (VCE). Aim of the study was to assess the prevalence of SB neoplasms by VCE in 14 acromegalic patients (Ac) in respect to 30 sex and age-matched control subjects and to correlate it with cancer risk factors and acromegaly-related parameters. Local Ethical committee approved the study. The Ac group (5M and 9F, age±S.D.: 52±11 years), included 4 patients cured by surgery and 10 medically treated (9 by somatostatin and 1 by dopamine agonists, 7 of whom with controlled disease). Cancer risk factors were similar in Ac and controls. History of the disease, GH and IGF-I levels, IGF-II and IGF-BP3 levels and metabolic parameters such as glucose tolerance, insulin resistance and insulin secretion were in addition investigated in Ac. Four gastrointestinal stromal nodular tumors (GIST) and 1 polyp of SB were detected in 16% of controls and in 29% of Ac (2 GISTs and 2 SB polyps, P: NS). In Ac the calculated relative risk for overall SB neoplasms was 1.74 (95% CI: 0.5418–5.424, P: NS), and for SB adenomas was 4.28 (95% CI: 0.4230–43.422, P: NS). Ac with positive VCE had a significantly longer duration of active disease (128.5±107.5 vs 45.0±44.6 months, P<0.05) than Ac with negative VCE, in spite of a younger age (48±4 vs 54±13 years, P: NS). No correlation with control of the disease, the presence of colon cancer and any other investigated parameters was found. In conclusions, these preliminary results show that acromegalic patients, mostly those with a long duration of active disease, might have a high risk also for SB tumours development, even if larger case studies are needed. VCE is a useful adjunctive diagnostic tool in acromegaly.