Duodenal adenocarcinoma with neuroendocrine features in a patient with acromegaly and thyroid papillary adenocarcinoma: a unique combination of endocrine neoplasia

Endocrine Journal

Kaheita Kakinoki¹  Kazuhide Ishikura¹  Ken-ichiro Kato¹  Yumie Takeshita¹  Seiko Sawada- Kitamura²  Hirofumi Misu¹  Shuichi Kaneko¹  Toshinari Takamura¹ 

[1] Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan;Department of Pathology, Kanazawa University Hospital, Kanazawa 920-8641, Japan

关键词: Acromegaly;    Duodenal cancer;    Neuroendocrine features;    Multiple endocrine tumors;    Octreotide;   

DOI  :  10.1507/endocrj.EJ11-0324

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(32)A 67-year-old woman with familial clustering of thyroid papillary adenocarcinoma was diagnosed with acromegaly due to pituitary macroadenoma.She had multiple skin vegetations, but had no parathyroid and pancreas diseases.Before transsphenoidal surgery, she was further diagnosed as having a duodenal tumor and multiple hypervascular liver nodules.Biopsy specimens from the duodenal tumor and liver nodules were diagnosed histologically as moderately differentiated adenocarcinoma.Immunohistochemically, the tumor cells were positive for chromogranin, synaptophysin and somatostatin receptor 2a, suggestive for neuroendocrine features.After surgery, the patient was not in biochemical remission, and octreotide treatment was initiated.The duodenal cancer was treated with chemotherapy (neoadjuvant cisplatin and S-1).After 24 months, the patient’s insulin-like growth factor I level had been normalized, and her liver tumors had not progressed macroscopically.This is a rare case of acromegaly associated with multiple endocrine tumors, not being categorized as conventional multiple endocrine neoplasia.Octreotide treatment might have had beneficial effects on our patient’s duodenal adenocarcinoma and liver metastases, both directly via SSTR2a and indirectly via GH suppression, thereby contributing to their slow progression.

【 授权许可】

Unknown