A male patient with acromegaly and breast cancer: treating acromegaly to control tumor progression
Identifieur interne : 007361 ( Ncbi/Merge ); précédent : 007360; suivant : 007362A male patient with acromegaly and breast cancer: treating acromegaly to control tumor progression
Auteurs : Paola Leporati [Italie] ; Rodolfo Fonte [Italie] ; Luca De Martinis [Italie] ; Alberto Zambelli [Italie] ; Flavia Magri [Italie] ; Lorenzo Pavesi [Italie] ; Mario Rotondi [Italie] ; Luca Chiovato [Italie]Source :
- BMC Cancer [ 1471-2407 ] ; 2015.
Abstract
Acromegaly is a rare disease associated with an increased risk of developing cancer.
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.
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.
Url:
DOI: 10.1186/s12885-015-1400-0
PubMed: 25962899
PubMed Central: 4436112
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Chair of Endocrinology, University of Pavia, 27100 Pavia</wicri:regionArea><wicri:noRegion>27100 Pavia</wicri:noRegion></affiliation></author><author><name sortKey="Fonte, Rodolfo" sort="Fonte, Rodolfo" uniqKey="Fonte R" first="Rodolfo" last="Fonte">Rodolfo Fonte</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri I.R.C.C.S., Laboratory for Endocrine Disruptors, Chair of Endocrinology, University of Pavia, 27100 Pavia, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri I.R.C.C.S., Laboratory for Endocrine Disruptors, Chair of Endocrinology, University of Pavia, 27100 Pavia</wicri:regionArea><wicri:noRegion>27100 Pavia</wicri:noRegion></affiliation></author><author><name sortKey="De Martinis, Luca" sort="De Martinis, Luca" uniqKey="De Martinis L" first="Luca" last="De Martinis">Luca De Martinis</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri I.R.C.C.S., Laboratory for Endocrine Disruptors, Chair of Endocrinology, University of Pavia, 27100 Pavia, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri I.R.C.C.S., Laboratory for Endocrine Disruptors, Chair of Endocrinology, University of Pavia, 27100 Pavia</wicri:regionArea><wicri:noRegion>27100 Pavia</wicri:noRegion></affiliation></author><author><name sortKey="Zambelli, Alberto" sort="Zambelli, Alberto" uniqKey="Zambelli A" first="Alberto" last="Zambelli">Alberto Zambelli</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Unit of Medical Oncology, Fondazione Salvatore Maugeri I.R.C.C.S., 27100 Pavia, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Unit of Medical Oncology, Fondazione Salvatore Maugeri I.R.C.C.S., 27100 Pavia</wicri:regionArea><wicri:noRegion>27100 Pavia</wicri:noRegion></affiliation></author><author><name sortKey="Magri, Flavia" sort="Magri, Flavia" uniqKey="Magri F" first="Flavia" last="Magri">Flavia Magri</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri I.R.C.C.S., Laboratory for Endocrine Disruptors, Chair of Endocrinology, University of Pavia, 27100 Pavia, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri I.R.C.C.S., Laboratory for Endocrine Disruptors, Chair of Endocrinology, University of Pavia, 27100 Pavia</wicri:regionArea><wicri:noRegion>27100 Pavia</wicri:noRegion></affiliation></author><author><name sortKey="Pavesi, Lorenzo" sort="Pavesi, Lorenzo" uniqKey="Pavesi L" first="Lorenzo" last="Pavesi">Lorenzo Pavesi</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Unit of Medical Oncology, Fondazione Salvatore Maugeri I.R.C.C.S., 27100 Pavia, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Unit of Medical Oncology, Fondazione Salvatore Maugeri I.R.C.C.S., 27100 Pavia</wicri:regionArea><wicri:noRegion>27100 Pavia</wicri:noRegion></affiliation></author><author><name sortKey="Rotondi, Mario" sort="Rotondi, Mario" uniqKey="Rotondi M" first="Mario" last="Rotondi">Mario Rotondi</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri I.R.C.C.S., Laboratory for Endocrine Disruptors, Chair of Endocrinology, University of Pavia, 27100 Pavia, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri I.R.C.C.S., Laboratory for Endocrine Disruptors, Chair of Endocrinology, University of Pavia, 27100 Pavia</wicri:regionArea><wicri:noRegion>27100 Pavia</wicri:noRegion></affiliation></author><author><name sortKey="Chiovato, Luca" sort="Chiovato, Luca" uniqKey="Chiovato L" first="Luca" last="Chiovato">Luca Chiovato</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri I.R.C.C.S., Laboratory for Endocrine Disruptors, Chair of Endocrinology, University of Pavia, 27100 Pavia, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri I.R.C.C.S., Laboratory for Endocrine Disruptors, Chair of Endocrinology, University of Pavia, 27100 Pavia</wicri:regionArea><wicri:noRegion>27100 Pavia</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Cancer</title><idno type="eISSN">1471-2407</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Acromegaly is a rare disease associated with an increased risk of developing cancer.</p></sec><sec><title>Case presentation</title><p>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.</p></sec><sec><title>Conclusions</title><p>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.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Ayuk, J" uniqKey="Ayuk J">J Ayuk</name></author><author><name sortKey="Sheppard, Mc" uniqKey="Sheppard M">MC Sheppard</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mestron, A" uniqKey="Mestron A">A Mestron</name></author><author><name sortKey="Webb, Sm" uniqKey="Webb S">SM Webb</name></author><author><name sortKey="Astorga, R" uniqKey="Astorga R">R Astorga</name></author><author><name sortKey="Benito, P" uniqKey="Benito P">P Benito</name></author><author><name sortKey="Catala, M" uniqKey="Catala M">M Catala</name></author><author><name sortKey="Gaztambide, S" uniqKey="Gaztambide S">S Gaztambide</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kauppinen M Kelin, R" uniqKey="Kauppinen M Kelin R">R 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article-type="case-report"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Cancer</journal-id><journal-id journal-id-type="iso-abbrev">BMC Cancer</journal-id><journal-title-group><journal-title>BMC Cancer</journal-title></journal-title-group><issn pub-type="epub">1471-2407</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25962899</article-id><article-id pub-id-type="pmc">4436112</article-id><article-id pub-id-type="publisher-id">1400</article-id><article-id pub-id-type="doi">10.1186/s12885-015-1400-0</article-id><article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject></subj-group></article-categories><title-group><article-title>A male patient with acromegaly and breast cancer: treating acromegaly to control tumor progression</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Leporati</surname><given-names>Paola</given-names></name><address><email>paola.leporati@gmail.com</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Fonte</surname><given-names>Rodolfo</given-names></name><address><email>rodolfo.fonte@fsm.it</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>de Martinis</surname><given-names>Luca</given-names></name><address><email>luca.demartinis@email.it</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Zambelli</surname><given-names>Alberto</given-names></name><address><email>alberto.zambelli@fsm.it</email></address><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Magri</surname><given-names>Flavia</given-names></name><address><email>flavia.magri@fsm.it</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Pavesi</surname><given-names>Lorenzo</given-names></name><address><email>lorenzo.pavesi@fsm.it</email></address><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Rotondi</surname><given-names>Mario</given-names></name><address><email>mario.rotondi@fsm.it</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Chiovato</surname><given-names>Luca</given-names></name><address><email>lchiovato@fsm.it</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><aff id="Aff1"><label>1</label>Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri I.R.C.C.S., Laboratory for Endocrine Disruptors, Chair of Endocrinology, University of Pavia, 27100 Pavia, Italy</aff><aff id="Aff2"><label>2</label>Unit of Medical Oncology, Fondazione Salvatore Maugeri I.R.C.C.S., 27100 Pavia, Italy</aff></contrib-group><pub-date pub-type="epub"><day>12</day><month>5</month><year>2015</year></pub-date><pub-date pub-type="pmc-release"><day>12</day><month>5</month><year>2015</year></pub-date><pub-date pub-type="collection"><year>2015</year></pub-date><volume>15</volume><elocation-id>397</elocation-id><history><date date-type="received"><day>13</day><month>5</month><year>2014</year></date><date date-type="accepted"><day>29</day><month>4</month><year>2015</year></date></history><permissions><copyright-statement>© Leporati et al.; licensee BioMed Central. 2015</copyright-statement><license license-type="open-access"><license-p>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 (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0">http://creativecommons.org/licenses/by/4.0</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><abstract id="Abs1"><sec><title>Background</title><p>Acromegaly is a rare disease associated with an increased risk of developing cancer.</p></sec><sec><title>Case presentation</title><p>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.</p></sec><sec><title>Conclusions</title><p>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.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>Acromegaly</kwd><kwd>Tamoxifen</kwd><kwd>Pegvisomant</kwd><kwd>Breast cancer</kwd></kwd-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2015</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc><affiliations><list><country><li>Italie</li></country></list><tree><country name="Italie"><noRegion><name sortKey="Leporati, Paola" sort="Leporati, Paola" uniqKey="Leporati P" first="Paola" last="Leporati">Paola Leporati</name></noRegion><name sortKey="Chiovato, Luca" sort="Chiovato, Luca" uniqKey="Chiovato L" first="Luca" last="Chiovato">Luca Chiovato</name><name sortKey="De Martinis, Luca" sort="De Martinis, Luca" uniqKey="De Martinis L" first="Luca" last="De Martinis">Luca De Martinis</name><name sortKey="Fonte, Rodolfo" sort="Fonte, Rodolfo" uniqKey="Fonte R" first="Rodolfo" last="Fonte">Rodolfo Fonte</name><name sortKey="Magri, Flavia" sort="Magri, Flavia" uniqKey="Magri F" first="Flavia" last="Magri">Flavia Magri</name><name sortKey="Pavesi, Lorenzo" sort="Pavesi, Lorenzo" uniqKey="Pavesi L" first="Lorenzo" last="Pavesi">Lorenzo Pavesi</name><name sortKey="Rotondi, Mario" sort="Rotondi, Mario" uniqKey="Rotondi M" first="Mario" last="Rotondi">Mario Rotondi</name><name sortKey="Zambelli, Alberto" sort="Zambelli, Alberto" uniqKey="Zambelli A" first="Alberto" last="Zambelli">Alberto Zambelli</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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