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Multiple myeloma in a patient with acromegaly.

Kang YM, Choi JH, Lee MJ, Ahn A, Park CJ, Chang K, Seo S, Hong SI, Kim MS - Endocrinol Metab (Seoul) (2014)

Bottom Line: Acromegaly is a slowly progressing condition resulting from excess growth hormone (GH), generally caused by a GH-secreting pituitary adenoma.Cancer is the third most common cause of mortality in patients with acromegaly, and insulin-like growth factor 1 (IGF-1) is known to influence tumor formation by increasing cell proliferation and inhibiting apoptosis.Multiple myeloma (MM) is a plasma cell neoplasm, and previous studies have suggested the possible role of IGF-1 in its development of MM.

View Article: PubMed Central - PubMed

Affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT
Acromegaly is a slowly progressing condition resulting from excess growth hormone (GH), generally caused by a GH-secreting pituitary adenoma. Cancer is the third most common cause of mortality in patients with acromegaly, and insulin-like growth factor 1 (IGF-1) is known to influence tumor formation by increasing cell proliferation and inhibiting apoptosis. Multiple myeloma (MM) is a plasma cell neoplasm, and previous studies have suggested the possible role of IGF-1 in its development of MM. However, no cases of acromegaly accompanied with MM have been reported in Asia to date. We here report the case of a 58-year-old woman with acromegaly accompanied with MM who presented with longstanding acromegalic manifestations resulting from a GH-secreting pituitary adenoma and also exhibited anemia, a reversed albumin/globulin ratio, and plasmacytosis on bone marrow examination. Because IGF-1 has been suggested to play an important role in the development and progression of MM, the patient promptly underwent surgical removal of the pituitary adenoma via a transsphenoidal approach. Since there is currently no consensus on therapeutic guidelines and suggested prognosis for MM with acromegaly, long-term follow-up of such cases is needed.

No MeSH data available.


Related in: MedlinePlus

(A) Physical examination of the patient revealed frontal bossing, thickened lips, and an enlarged nose. (B) Exaggerated frontal bossing (arrow) observed from the side. Disproportionately enlarged (acromegalic) hands (C) and feet (D) were also seen.
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Figure 1: (A) Physical examination of the patient revealed frontal bossing, thickened lips, and an enlarged nose. (B) Exaggerated frontal bossing (arrow) observed from the side. Disproportionately enlarged (acromegalic) hands (C) and feet (D) were also seen.

Mentions: On admission, the patient's blood pressure was 120/80 mm Hg. She had a heart rate of 86 per minute, a respiratory rate of 20 per minute, and a body temperature of 36.5℃. During physical examination, the facial enlargement with frontal bossing was noticed, as was the disproportionate enlargement of the tongue, nose, lips, hands, and feet (Fig. 1). Hypertrichosis was seen, especially in the lower extremities. Soft tissue swelling was noted, and the skin folds were thickened.


Multiple myeloma in a patient with acromegaly.

Kang YM, Choi JH, Lee MJ, Ahn A, Park CJ, Chang K, Seo S, Hong SI, Kim MS - Endocrinol Metab (Seoul) (2014)

(A) Physical examination of the patient revealed frontal bossing, thickened lips, and an enlarged nose. (B) Exaggerated frontal bossing (arrow) observed from the side. Disproportionately enlarged (acromegalic) hands (C) and feet (D) were also seen.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4384674&req=5

Figure 1: (A) Physical examination of the patient revealed frontal bossing, thickened lips, and an enlarged nose. (B) Exaggerated frontal bossing (arrow) observed from the side. Disproportionately enlarged (acromegalic) hands (C) and feet (D) were also seen.
Mentions: On admission, the patient's blood pressure was 120/80 mm Hg. She had a heart rate of 86 per minute, a respiratory rate of 20 per minute, and a body temperature of 36.5℃. During physical examination, the facial enlargement with frontal bossing was noticed, as was the disproportionate enlargement of the tongue, nose, lips, hands, and feet (Fig. 1). Hypertrichosis was seen, especially in the lower extremities. Soft tissue swelling was noted, and the skin folds were thickened.

Bottom Line: Acromegaly is a slowly progressing condition resulting from excess growth hormone (GH), generally caused by a GH-secreting pituitary adenoma.Cancer is the third most common cause of mortality in patients with acromegaly, and insulin-like growth factor 1 (IGF-1) is known to influence tumor formation by increasing cell proliferation and inhibiting apoptosis.Multiple myeloma (MM) is a plasma cell neoplasm, and previous studies have suggested the possible role of IGF-1 in its development of MM.

View Article: PubMed Central - PubMed

Affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT
Acromegaly is a slowly progressing condition resulting from excess growth hormone (GH), generally caused by a GH-secreting pituitary adenoma. Cancer is the third most common cause of mortality in patients with acromegaly, and insulin-like growth factor 1 (IGF-1) is known to influence tumor formation by increasing cell proliferation and inhibiting apoptosis. Multiple myeloma (MM) is a plasma cell neoplasm, and previous studies have suggested the possible role of IGF-1 in its development of MM. However, no cases of acromegaly accompanied with MM have been reported in Asia to date. We here report the case of a 58-year-old woman with acromegaly accompanied with MM who presented with longstanding acromegalic manifestations resulting from a GH-secreting pituitary adenoma and also exhibited anemia, a reversed albumin/globulin ratio, and plasmacytosis on bone marrow examination. Because IGF-1 has been suggested to play an important role in the development and progression of MM, the patient promptly underwent surgical removal of the pituitary adenoma via a transsphenoidal approach. Since there is currently no consensus on therapeutic guidelines and suggested prognosis for MM with acromegaly, long-term follow-up of such cases is needed.

No MeSH data available.


Related in: MedlinePlus