Growth of an aggressive tumor during pregnancy in an acromegalic patient

Endocrine Journal

Christina M. Takiya²  Mônica R. Gadelha¹  Leandro Kasuki¹  Leonardo Vieira Neto¹ 

[1] Serviço de Endocrinologia, Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil;Laboratorio de Patologia Celular, UFRJ, Rio de Janeiro, Brazil

关键词: Acromegaly;    Pregnancy;    Aryl hydrocarbon receptor-interacting protein;    Ki-67;    Aggressive adenomas;   

DOI  :  10.1507/endocrj.EJ11-0306

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(26)Cited-By(3)Pregnancy in acromegalic patients is a rare event, but is usually uneventful, with stable GH and IGF-I levels and no tumor enlargement.Medical treatment can usually be withdrawn without problems and although no major adverse event has been reported, the suspension of drug treatments is generally recommended.No case report exists in the literature regarding evolution of a somatotropinoma with invasiveness markers throughout pregnancy.We report a case of an acromegalic patient who was submitted to surgery and treated with octreotide LAR maintaining a stable residual tumor and an IGF-I close to the normal levels.Her tumor presented with a high Ki-67 (11.6%) and a low aryl hydrocarbon receptor-interacting protein (AIP) expression.When she became pregnant, octreotide LAR was withdrawn, and despite remaining asymptomatic during pregnancy, tumor growth occurred with compression of surrounding structures.In conclusion, pregnancy in acromegalic patients has usually a favorable prognosis with no tumor growth.However, in the presence of high Ki-67 labeling index and low AIP expression, tumor enlargement may occur and somatostatin analogue treatment throughout the pregnancy should be considered.

【 授权许可】

Unknown