Growth of an aggressive tumor during pregnancy in an acromegalic patient.

Abstract:

: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 Medical treatment can usually be withdrawn without problems and although no major adverse event has been reported, the suspension of drug treatments is generally recommended.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 When she became pregnant, octreotide LAR was withdrawn, and despite remaining asymptomatic during pregnancy, tumor growth occurred with compression of surrounding structures.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.

journal_name

Endocr J

journal_title

Endocrine journal

authors

Kasuki L,Neto LV,Takiya CM,Gadelha MR

doi

10.1507/endocrj.ej11-0306

subject

Has Abstract

pub_date

2012-01-01 00:00:00

pages

313-9

issue

4

eissn

0918-8959

issn

1348-4540

pii

JST.JSTAGE/endocrj/EJ11-0306

journal_volume

59

pub_type

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