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A male patient with acromegaly and breast cancer: treating acromegaly to control tumor progression

BACKGROUND: Acromegaly is a rare disease associated with an increased risk of developing cancer. CASE PRESENTATION: We report the case of a 72-year-old man who was diagnosed with acromegaly (IGF-1 770 ng/ml) and breast cancer. Four years before he suffered from a colon-rectal cancer. Pituitary surge...

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Autores principales: Leporati, Paola, Fonte, Rodolfo, de Martinis, Luca, Zambelli, Alberto, Magri, Flavia, Pavesi, Lorenzo, Rotondi, Mario, Chiovato, Luca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4436112/
https://www.ncbi.nlm.nih.gov/pubmed/25962899
http://dx.doi.org/10.1186/s12885-015-1400-0
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author Leporati, Paola
Fonte, Rodolfo
de Martinis, Luca
Zambelli, Alberto
Magri, Flavia
Pavesi, Lorenzo
Rotondi, Mario
Chiovato, Luca
author_facet Leporati, Paola
Fonte, Rodolfo
de Martinis, Luca
Zambelli, Alberto
Magri, Flavia
Pavesi, Lorenzo
Rotondi, Mario
Chiovato, Luca
author_sort Leporati, Paola
collection PubMed
description BACKGROUND: Acromegaly is a rare disease associated with an increased risk of developing cancer. CASE PRESENTATION: We report the case of a 72-year-old man who was diagnosed with acromegaly (IGF-1 770 ng/ml) and breast cancer. Four years before he suffered from a colon-rectal cancer. Pituitary surgery and octreotide-LAR treatment failed to control acromegaly. Normalization of IGF-1 (97 ng/ml) was obtained with pegvisomant therapy. Four years after breast cancer surgery, 2 pulmonary metastases were detected at chest CT. The patient was started on anastrozole, but, contrary to medical advice, he stopped pegvisomant treatment (IGF-I 453 ng/ml). Four months later, chest CT revealed an increase in size of the metastatic lesion of the left lung. The patient was shifted from anastrozole to tamoxifen and was restarted on pegvisomant, with normalization of serum IGF-1 levels (90 ng/ml). Four months later, a reduction in size of the metastatic lesion of the left lung was detected by CT. Subsequent CT scans throughout a 24-month follow-up showed a further reduction in size and then a stabilization of the metastasis. CONCLUSIONS: This is the first report of a male patient with acromegaly and breast cancer. The clinical course of breast cancer was closely related to the metabolic control of acromegaly. The rapid progression of metastatic lesion was temporally related to stopping pegvisomant treatment and paralleled a rise in serum IGF-1 levels. Normalization of IGF-1 after re-starting pegvisomant impressively reduced the progression of metastatic breast lesions. Control of acromegaly is mandatory in acromegalic patients with cancer.
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spelling pubmed-44361122015-05-20 A male patient with acromegaly and breast cancer: treating acromegaly to control tumor progression Leporati, Paola Fonte, Rodolfo de Martinis, Luca Zambelli, Alberto Magri, Flavia Pavesi, Lorenzo Rotondi, Mario Chiovato, Luca BMC Cancer Case Report BACKGROUND: Acromegaly is a rare disease associated with an increased risk of developing cancer. CASE PRESENTATION: We report the case of a 72-year-old man who was diagnosed with acromegaly (IGF-1 770 ng/ml) and breast cancer. Four years before he suffered from a colon-rectal cancer. Pituitary surgery and octreotide-LAR treatment failed to control acromegaly. Normalization of IGF-1 (97 ng/ml) was obtained with pegvisomant therapy. Four years after breast cancer surgery, 2 pulmonary metastases were detected at chest CT. The patient was started on anastrozole, but, contrary to medical advice, he stopped pegvisomant treatment (IGF-I 453 ng/ml). Four months later, chest CT revealed an increase in size of the metastatic lesion of the left lung. The patient was shifted from anastrozole to tamoxifen and was restarted on pegvisomant, with normalization of serum IGF-1 levels (90 ng/ml). Four months later, a reduction in size of the metastatic lesion of the left lung was detected by CT. Subsequent CT scans throughout a 24-month follow-up showed a further reduction in size and then a stabilization of the metastasis. CONCLUSIONS: This is the first report of a male patient with acromegaly and breast cancer. The clinical course of breast cancer was closely related to the metabolic control of acromegaly. The rapid progression of metastatic lesion was temporally related to stopping pegvisomant treatment and paralleled a rise in serum IGF-1 levels. Normalization of IGF-1 after re-starting pegvisomant impressively reduced the progression of metastatic breast lesions. Control of acromegaly is mandatory in acromegalic patients with cancer. BioMed Central 2015-05-12 /pmc/articles/PMC4436112/ /pubmed/25962899 http://dx.doi.org/10.1186/s12885-015-1400-0 Text en © Leporati et al.; licensee BioMed Central. 2015 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Leporati, Paola
Fonte, Rodolfo
de Martinis, Luca
Zambelli, Alberto
Magri, Flavia
Pavesi, Lorenzo
Rotondi, Mario
Chiovato, Luca
A male patient with acromegaly and breast cancer: treating acromegaly to control tumor progression
title A male patient with acromegaly and breast cancer: treating acromegaly to control tumor progression
title_full A male patient with acromegaly and breast cancer: treating acromegaly to control tumor progression
title_fullStr A male patient with acromegaly and breast cancer: treating acromegaly to control tumor progression
title_full_unstemmed A male patient with acromegaly and breast cancer: treating acromegaly to control tumor progression
title_short A male patient with acromegaly and breast cancer: treating acromegaly to control tumor progression
title_sort male patient with acromegaly and breast cancer: treating acromegaly to control tumor progression
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4436112/
https://www.ncbi.nlm.nih.gov/pubmed/25962899
http://dx.doi.org/10.1186/s12885-015-1400-0
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