Definitive role of surgery in management of acromegaly due to ectopic growth hormone secretion: review of literature

Authors

  • Anuj Singh Department of Surgical Oncology, NIMS University, Jaipur, Rajasthan, India https://orcid.org/0000-0001-9607-0588
  • Naveen Sharma Department of Surgical Oncology, NIMS University, Jaipur, Rajasthan, India
  • Jaiveer S. Shekhawat Department of Surgical Oncology, NIMS University, Jaipur, Rajasthan, India
  • Mahaveer Singh Department of Endocrinology, NIMS University, Jaipur, Rajasthan, India
  • Ram C. Sherawat Department of Cadiothoracic and Vascular Surgery, NIMS University, Jaipur, Rajasthan, India
  • Anushree Chaturvedi Department of Medical Oncology, NIMS University, Jaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20250271

Keywords:

Ectopic growth hormone, Ectopic acromegaly, Surgery for acromegaly

Abstract

Acromegaly, characterized by excessive growth hormone (GH) secretion, typically arises from pituitary adenomas. Ectopic GH production from non-pituitary tumors, such as carcinoid tumors, is exceedingly rare, <1%. The majority of the growth hormone-releasing hormone (GHRH) - secreting tumors are bronchial carcinoids. Other GHRH-secreting tumors in decreasing order of occurrence are pancreatic adenomas, gastro-intestinal tumors, thymic tumors, and tumors associated with the MEN-I syndrome. We present a case of a 43-year-old female who presented with features consistent with acromegaly and was found to have an ectopic source of GH from a mediastinal tumor. Diagnostic evaluation included biochemical testing, imaging studies, and histopathological confirmation. Surgical intervention led to complete resolution of clinical symptoms and normalization of GH levels. This case highlights the diagnostic challenges posed by ectopic GH secretion and emphasizes the critical role of surgery in achieving favorable outcomes in such rare presentations of acromegaly.

Metrics

Metrics Loading ...

References

Thorner MO, Frohman LA, Leong DA, Thominet J, Downs T, Hellmann P, et al. Extrahypothalamic growth-hormone-releasing-factor (GRF) secretion is a rare cause of acromegaly: plasma GRF levels in 177 acromegalic patients. J Clin Endocrinol Metab. 1984;59:846-9. DOI: https://doi.org/10.1210/jcem-59-5-846

Losa M, von Werder K. Pathophysiology and clinical aspects of the ectopic GH-releasing hormone syndrome. Clin Endocrinol. 1997;47:123-35. DOI: https://doi.org/10.1046/j.1365-2265.1997.2311048.x

Altmann HW, Schuetz W. On a bronchus carcinoid containing bone (morphological and clinical observations in an acromegalic patient). Beitr Pathol Anat. 1959;120:455-73.

Shalet SM, Beardwell CG, MacFarlane IA, Ellison ML, Norman CM, Rees LH, et al. Acromegaly due to production of a growth hormone releasing factor by a bronchial carcinoid tumor. Clin Endocrinol (Oxf). 1979;10:61-7. DOI: https://doi.org/10.1111/j.1365-2265.1979.tb03034.x

Guillemin R, Brazeau P, Bohlen P, Esch F, Ling N, Wehrenberg WB. Growth-hormone releasingfactor from a human pancreatic tumor that caused acromegaly. Science. 1982;218:585-7. DOI: https://doi.org/10.1126/science.6812220

Rivier J, Spiess J, Thorner M, Vale W. Characterization of a growth hormone-releasing factor from a human pancreatic islet tumour. Nature. 1982;300:276-8. DOI: https://doi.org/10.1038/300276a0

Borson-Chazot F, Garby L, Raverot G, Claustrat F, Raverot V, Sassolas G, et al. Acromegaly induced by ectopic secretion of GHRH: a review 30 years after GHRH discovery. Annales d’ Endocrinologie. 2012;73:497-502. DOI: https://doi.org/10.1016/j.ando.2012.09.004

Losa M, Schopohl J, von Werder K. Ectopic secretion of growth hormone-releasing hormone in man. J Endocrinol Invest. 1993;16:69-81. DOI: https://doi.org/10.1007/BF03345835

van Hoek M, Hofland LJ, de Rijke YB, van Nederveen FH, de Krijger RR, van Koetsveld PM, et al. Effects of somatostatin analogs on a growth hormone-releasing hormone secreting bronchial carcinoid, in vivo and in vitro studies. J Clin Endocrinol Metab. 2009;94:428-33. DOI: https://doi.org/10.1210/jc.2008-1712

Downloads

Published

2025-01-30

How to Cite

Singh, A., Sharma, N., Shekhawat, J. S., Singh, M., Sherawat, R. C., & Chaturvedi, A. (2025). Definitive role of surgery in management of acromegaly due to ectopic growth hormone secretion: review of literature. International Journal of Research in Medical Sciences, 13(2), 867–870. https://doi.org/10.18203/2320-6012.ijrms20250271

Issue

Section

Case Reports