The clinical and biochemical spectrum of ectopic acromegaly.
Best Pract Res Clin Endocrinol Metab
; 38(3): 101877, 2024 May.
Article
em En
| MEDLINE
| ID: mdl-38413286
ABSTRACT
Ectopic acromegaly is a rare condition caused by extrapituitary central or peripheral neuroendocrine tumours (NET) that hypersecrete GH or, more commonly, GHRH. It affects less than 1% of acromegaly patients and a misdiagnosis of classic acromegaly can lead to an inappropriate pituitary surgery. Four types of ectopic acromegaly have been described 1) Central ectopic GH-secretion Careful cross-sectional imaging is required to exclude ectopic pituitary adenomas. 2) Peripheral GH secretion Extremely rare. 3) Central ectopic GHRH secretion Sellar gangliocytomas immunohistochemically positive for GHRH are found after pituitary surgery. 4) Peripheral GHRH secretion The most common type of ectopic acromegaly is due to peripheral GHRH-secreting NETs. Tumours are large and usually located in the lungs or pancreas. Pituitary hyperplasia resulting from chronic GHRH stimulation is difficult to detect or can be misinterpreted as pituitary adenoma in the MRI. Measurement of serum GHRH levels is a specific and useful diagnostic tool. Surgery of GHRH-secreting NETs is often curative.
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Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Acromegalia
/
Hormônio Liberador de Hormônio do Crescimento
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article