Endocrine Abstracts (2009) 20 P197

Incidence of benign and malignant neoplasms in acromegalic patients at a single institution

Agata Baldys-Waligorska, Filip Golkowski, Anna Krzentowska, Grzegorz Sokolowski & Alicja Hubalewska-Dydejczyk

Department of Endocrinology, Collegium Medicum, Jagiellonian University, Krakow, Poland.

Introduction: In acromegalic patients the incidence of benign and malignant neoplasms, appears to be higher than that in the standard population. Our aim was to evaluate the incidence of tumours in acromegalic patients treated at our Department.

Materials and methods: Over the years 1983–2008, 101 acromegalic patients (mean age 51.8±15.4 years), were diagnosed and treated in our Department. Pituitary macroadenoma and microadenoma were stated in 63.4 and 25.7% of these patients, respectively (no data available for 10.9%). Mean observation period was 9.4±6.5 years. We only scored neoplasms in patients primarily diagnosed with acromegaly. Our study was based on retrospective analysis of patient history and on recent screening for colon, breast, thyroid and prostate cancer.

Results: The median concentrations of hGH and IGF-1 prior to treatment were 20.2 (IQR=34.9) ng/ml and 764.5 (IQR=569.6) ng/ml, respectively. The current median hGH and IGF-1 concentrations were 2.1 (IQR=4.0) ng/ml and 304.3 (IQR=397.3) ng/ml, being statistically different from the former values (P< Per 101 patients we observed incidences of: nodular goitre-63.0%, polyps of the colon-13%; uterine myoma and polyps-12% and 4.0%; prostate adenoma-2.0%; meningioma-4.0%; adrenal adenoma-2.0%; parathyroid adenoma-1.0%. Thyroid cancer, endometrium and cervix cancer were the most frequent malignant tumours (3% each); colon cancer incidence was 2.0%. Single cases of breast, stomach, skin and small-cell lung cancer were also observed. The dependence of the number of malignant neoplasms on the duration of uncontrolled disease: less than 5 years and over 5 years, was found to be statistically significant (P<0.05).

Conclusions: 1. We suggest an overall increase of tumour incidence in acromegalic patients. Prospective studies are required to resolve the significance of this observation.

2. The number of malignant neoplasms was significantly higher in patients with over 5 years of uncontrolled disease. No difference was found in the number of malignant neoplasms over the total duration of acromegaly (<10 years and >10 years).

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