Cancer Incidence in Patients With Acromegaly: A Cohort Study and Meta-Analysis of the Literature

Dal, Jakob; Leisner, Michelle Z; Hermansen, Kasper; Farkas, Dóra Körmendiné; Bengtsen, Mads Bisgaard; Kistorp, Caroline; Andersen, Marianne; Feldt‐Rasmussen, Ulla; Dekkers, Olaf M.; Sørensen, Henrik Toft; Jørgensen, Jens Otto Lunde

doi:10.1210/jc.2017-02457

Cited by 110 publications

(106 citation statements)

References 34 publications

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“…The same group also performed a meta-analysis and found ACRO had a significantly higher risk of thyroid lesions (OR = 3.3, p < 0.001) and cancer (OR = 3.9, p < 0.001). These results have been confirmed by a meta-analysis by Dal et al, which found a standardized incidence ratio for thyroid lesions of 9.2 among ACRO [42]. The presence, dimensions, and evolution of nodules seems to be influenced by disease activity [11].…”

Section: Thyroidmentioning

confidence: 68%

“…Other authors have shown a higher incidence of prostatic structural alteration, such as cysts, nodules, and calcifications [41]. However, a recent meta-analysis documented that prevalence of prostate cancer seems to be just slightly or not significantly elevated, with a standardized incidence ratio of 1.2 in ACRO compared to general population [42]. For these reasons, many experts suggest the same screening approach to prostate pathology in ACRO as in general population [11].…”

Section: Prostatementioning

confidence: 99%

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Acromegaly and ultrasound: how, when and why?

Parolin

Dassiè

Vettor

et al. 2019

J Endocrinol Invest

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Background Acromegaly is a rare disease caused by an excess of growth hormone and insulin-like growth factor 1. It is usually diagnosed because of typical signs such as macroglossia, acral enlargement, jaw prognathism and malocclusion. Systemic complications are a major cause of morbidity and mortality in acromegaly, and many patients remain undiagnosed for several years. Increased ultrasound (US) application in the general population, and including among acromegaly patients, has revealed many suggestive features which, taken together with clinical suspicion, could induce suspicion of this disease. Purpose This review describes main US features in acromegaly. Echocardiography shows a typical cardiomyopathy, characterized by left ventricular hypertrophy, diastolic and systolic dysfunction, aortic and mitral regurgitation, and increased aortic root diameters. US preclinical markers of atherosclerosis, such as intima media thickness (IMT), seem also to be impaired. Visceromegaly and increased organ stiffness are other features of acromegaly, including enlarged prostate, kidneys, liver, and thyroid. In addition, other US findings are: renal cysts, micronephrolithiasis, impairment of renal haemodynamic parameters, gallstones and gallbladder polyps, hepatic steatosis, thyroid nodules, multinodular goiter, and polycystic ovaries. Musculoskeletal US findings are increased cartilage thickness, impaired density and elasticity of bones, nerve enlargement, carpal and cubital tunnel syndrome, and trigger finger. Conclusions Acromegaly patients frequently present systemic complications and a diagnostic delay. US features of acromegaly are not specific, but could potentially have a key role in early detection of the disease in the presence of typical clinical features.

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Section: Thyroidmentioning

confidence: 68%

Section: Prostatementioning

confidence: 99%

Acromegaly and ultrasound: how, when and why?

Parolin

Dassiè

Vettor

et al. 2019

J Endocrinol Invest

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“…Furthermore, evidence from animal and human studies support a direct role for GH in the progression of neoplastic epithelial growth (18)(19)(20). Excess pituitary tumor GH secretion in acromegaly results in soft tissue overgrowth and increased adenoma formation in the colon, skin, thyroid, and prostate (21), and it is associated with increased risk for colorectal carcinoma (22,23). GH triggers epithelial-to-mesenchymal transition, creating a proneoplastic mucosal environment (24)(25)(26)(27).…”

Section: Introductionmentioning

confidence: 99%

Excess growth hormone suppresses DNA damage repair in epithelial cells

Chesnokova¹,

Zonis²,

Barrett

et al. 2019

JCI Insight

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“…The frequency of differentiated thyroid carcinomas (DTCs) is increased in patients with somatotropinomas, with papillary thyroid carcinoma (PTC) being the most frequently reported type (up to 25%) [8][9][10][11][12][13]. As thyroid follicular epithelial cells express insulin-like growth factor 1 (IGF-1) receptors and IGF-1 is an important factor for promoting replication and reducing apoptosis of these cells [14], IGF-1 could potentially be linked to the promotion of thyroid cancer in acromegalic patients.…”

Section: Introductionmentioning

confidence: 99%

The role of AIP variants in pituitary adenomas and concomitant thyroid carcinomas in the Netherlands: a nationwide pathology registry (PALGA) study

et al. 2020

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Purpose Germline mutations in the aryl-hydrocarbon receptor interacting protein (AIP) have been identified often in the setting of familial isolated pituitary adenoma (FIPA). To date there is no strong evidence linking germline AIP mutations to other neoplasms apart from the pituitary. Our primary objective was to investigate the prevalence of AIP gene mutations and mutations in genes that have been associated with neuroendocrine tumors in series of tumors from patients presenting with both pituitary adenomas and differentiated thyroid carcinomas (DTCs). Methods Pathology samples were retrieved from all pituitary adenomas in patients with concomitant DTCs, including one with a known germline AIP variant. Subsequently, two additional patients with known germline AIP variants were included, of which one presented only with a follicular thyroid carcinoma (FTC). Results In total, 17 patients (14 DTCs and 15 pituitary adenomas) were investigated by targeted next generation sequencing (NGS). The pituitary tumor samples revealed no mutations, while among the thyroid tumor samples BRAF (6/14, 42.9%) was the most frequently mutated gene, followed by NRAS (3/11, 27.3%). In one AIP-mutated FIPA kindred, the AIP-variant c.853C>T; p.Q285* was confirmed in the FTC specimen, including evidence of loss of heterozygosity (LOH) at the AIP locus in the tumor DNA. Conclusion Although most observed variants in pituitary adenomas and DTCs were similar to those of sporadic DTCs, we confirmed in one AIP mutation-positive case the AIP-variant and LOH at this locus in an FTC specimen, which raises the potential role of the AIP mutation as a rare initiating event.

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Cancer Incidence in Patients With Acromegaly: A Cohort Study and Meta-Analysis of the Literature

Abstract: Cancer incidence rates were slightly elevated in patients with acromegaly in our study, and this finding was supported by the meta-analysis of 23 studies, although it also suggested the presence of selection bias in some earlier studies.

Cited by 110 publications

References 34 publications

Acromegaly and ultrasound: how, when and why?

Acromegaly and ultrasound: how, when and why?

Excess growth hormone suppresses DNA damage repair in epithelial cells

The role of AIP variants in pituitary adenomas and concomitant thyroid carcinomas in the Netherlands: a nationwide pathology registry (PALGA) study

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