Mina Saeed, MD, Christine Tat, MD, Jan Kaminski, MD, Joaquin Estrada, MD. UIC-MGH
Abstract: Acromegaly is a debilitating condition marked by excessive production of growth hormone. This leads to disfiguration, cardiopulmonary complications, and increased risk for cancer. With up to a two-fold increased risk of developing colon cancer and worse prognosis for diagnosed patients, earlier and more frequent screening has been recommended. We present a case of a 54-year-old Hispanic male with acromegaly who presented to our hospital with hematochezia and weight loss. A near-obstructing rectal adenocarcinoma with metastasis to the liver was discovered. After completing neoadjuvant chemoradiotherapy, he underwent laparoscopic low-anterior colon resection and simultaneous open hepatic trisegmentectomy. In this case report, we review the literature and current guidelines in screening this high-risk group of patients.
Ali Riza Koksal, Meltem Ergun, Salih Boga, et al., “Increased Prevalence of Colorectal Polyp in Acromegaly Patients: A Case-Control Study,” Diagnostic and Therapeutic Endoscopy, vol. 2014, Article ID 152049, 4 pages, 2014. doi:10.1155/2014/152049
Dutta, Pinaki, et al. “Colonic Neoplasia in Acromegaly: Increased Proliferation or Deceased Apoptosis?” Pituitary, vol. 15, no. 2, 2011, pp. 166–173., doi:10.1007/s11102-011-0300-9
Dworakowska, D, et al. “Repeated Colonoscopic Screening of Patients with Acromegaly: 15-Year Experience Identifies Those at Risk of New Colonic Neoplasia and Allows for Effective Screening Guidelines.” European Journal of Endocrinology, 1 July 2010
Lois K, Bukowczan J, Perros P, Jones S, Gunn M, James RA. The role of colonoscopic screening in acromegaly revisited: review of current literature and practice guidelines. Pituitary. 2015;18:568-574.
Renehan, Andrew G., and Bernadette M. Brennan. “Acromegaly, Growth Hormone and Cancer Risk.” Best Practice & Research Clinical Endocrinology & Metabolism, vol. 22, no. 4, 2008, pp. 639–657., doi:10.1016/j.beem.2008.08.011.
Rokkas T, Pistiolas D, Sechopoulos P, Margantinis G, Koukoulis G. Risk of colorectal neoplasm in patients with acromegaly: A meta-analysis. World Journal of Gastroenterology?: WJG. 2008;14(22):3484-3489. doi:10.3748/wjg.14.3484.
Torre, Maria Luisa, et al. “MTHFRÂ C677T Polymorphism, Folate Status and Colon Cancer Risk in Acromegalic Patients.” Pituitary, 2013, doi:10.1007/s11102-013-0499-8.
Wassenaar, M. J. E., et al. “Acromegaly Is Associated with an Increased Prevalence of Colonic Diverticula: A Case-Control Study.” The Journal of Clinical Endocrinology & Metabolism, vol. 95, no. 5, 2010, pp. 2073–2079., doi:10.1210/jc.2009-1714.
Yamamoto M, Fukuoka H, Iguchi G, Matsumoto R, Takahashi M, Nishizawa H, et al. The prevalence and associated factors of colorectal neoplasms in acromegaly: a single center based study. Pituitary (2014). doi:10.1007/s11102-014-0580-y
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87552
Program Number: P289
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster