Yukiko Odake1, Hidenori Fukuoka2, Masaaki Yamamoto1, Yoshifumi Arisaka3, Junya Konishi4, Kenichi Yoshida1, Ryusaku Matsumoto1, Hironori Bando1, Kentaro Suda1, Hitoshi Nishizawa5, Genzo Iguchi5, Shozo Yamada6, Wataru Ogawa1, Yutaka Takahashi1. 1. Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan. 2. Division of Diabetes and Endocrinology, Kobe University Hospital, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. fukuokah@med.kobe-u.ac.jp. 3. Department of Gastroenterology, Kobe University Graduate School of Medicine, Kobe, Japan. 4. Department of Medical and Healthcare Systems, Kobe University Graduate School of Medicine, Kobe, Japan. 5. Division of Diabetes and Endocrinology, Kobe University Hospital, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. 6. Department of Hypothalamic and Pituitary Surgery, Toranomon Hospital, Tokyo, Japan.
Abstract
PURPOSE: Acromegaly is a disease associated with an increased risk for several kinds of neoplasms including colon and thyroid cancer. Although the association between acromegaly and pancreatic neoplasms has not been elucidated, it has recently been reported that GNAS gene mutations were found in 58% of intraductal papillary mucinous neoplasms (IPMNs), which are representative pancreatic cystic lesions, suggesting a link between IPMNs and acromegaly. To assess the prevalence of pancreatic cystic lesions in patients with acromegaly, we performed a retrospective cross-sectional single institute study. METHODS: Thirty consecutive acromegalic patients (20 females and 10 males; mean age, 60.9 ± 11.9 years) who underwent abdominal contrast-enhanced computed tomography or magnetic resonance imaging between 2007 and 2015 at Kobe University Hospital were recruited. We also analyzed the relationship between presence of pancreatic cystic lesions and somatic GNAS mutations in pituitary tumors. RESULTS: Seventeen of 30 (56.7%) patients studied had pancreatic cystic lesions. Nine of 17 patients (52.9%) were diagnosed with IPMNs based on imaging findings. These results suggest that the prevalence of IPMNs may be higher in acromegalic patients in acromegalic patients than historically observed in control patients (up to 13.5%). In patients with pancreatic cystic lesions, the mean patient age was higher and the duration of disease was longer than in those without pancreatic cystic lesions (67.0 ± 2.3 vs. 53.0 ± 2.7 years, p < 0.001, 15.5 ± 2.4 vs. 7.3 ± 2.8 years, p = 0.04). There were no differences in serum growth hormone levels or insulin-like growth factor standard deviation scores between these two groups (21.3 ± 6.4 vs. 23.0 ± 7.4 ng/ml, p = 0.86, 6.6 ± 0.5 vs. 8.0 ± 0.6, p = 0.70). Neither the presence of somatic GNAS mutation in a pituitary tumor nor low signal intensity of the tumor in T2 weighted magnetic resonance imaging was associated with the presence of pancreatic cystic lesions. CONCLUSIONS: These data demonstrate that old or long-suffering patients with acromegaly have a higher prevalence of pancreatic cystic lesions. Moreover, the prevalence of pancreatic cystic lesions may be increased in acromegalic patients.
PURPOSE:Acromegaly is a disease associated with an increased risk for several kinds of neoplasms including colon and thyroid cancer. Although the association between acromegaly and pancreatic neoplasms has not been elucidated, it has recently been reported that GNAS gene mutations were found in 58% of intraductal papillary mucinous neoplasms (IPMNs), which are representative pancreatic cystic lesions, suggesting a link between IPMNs and acromegaly. To assess the prevalence of pancreatic cystic lesions in patients with acromegaly, we performed a retrospective cross-sectional single institute study. METHODS: Thirty consecutive acromegalicpatients (20 females and 10 males; mean age, 60.9 ± 11.9 years) who underwent abdominal contrast-enhanced computed tomography or magnetic resonance imaging between 2007 and 2015 at Kobe University Hospital were recruited. We also analyzed the relationship between presence of pancreatic cystic lesions and somatic GNAS mutations in pituitary tumors. RESULTS: Seventeen of 30 (56.7%) patients studied had pancreatic cystic lesions. Nine of 17 patients (52.9%) were diagnosed with IPMNs based on imaging findings. These results suggest that the prevalence of IPMNs may be higher in acromegalicpatients in acromegalicpatients than historically observed in control patients (up to 13.5%). In patients with pancreatic cystic lesions, the mean patient age was higher and the duration of disease was longer than in those without pancreatic cystic lesions (67.0 ± 2.3 vs. 53.0 ± 2.7 years, p < 0.001, 15.5 ± 2.4 vs. 7.3 ± 2.8 years, p = 0.04). There were no differences in serum growth hormone levels or insulin-like growth factor standard deviation scores between these two groups (21.3 ± 6.4 vs. 23.0 ± 7.4 ng/ml, p = 0.86, 6.6 ± 0.5 vs. 8.0 ± 0.6, p = 0.70). Neither the presence of somatic GNAS mutation in a pituitary tumor nor low signal intensity of the tumor in T2 weighted magnetic resonance imaging was associated with the presence of pancreatic cystic lesions. CONCLUSIONS: These data demonstrate that old or long-suffering patients with acromegaly have a higher prevalence of pancreatic cystic lesions. Moreover, the prevalence of pancreatic cystic lesions may be increased in acromegalicpatients.
Authors: E Parker; L J Newby; C C Sharpe; S Rossetti; A J Streets; P C Harris; M J O'Hare; A C M Ong Journal: Kidney Int Date: 2007-03-28 Impact factor: 10.612
Authors: Laurence Katznelson; John L D Atkinson; David M Cook; Shereen Z Ezzat; Amir H Hamrahian; Karen K Miller Journal: Endocr Pract Date: 2011 Jul-Aug Impact factor: 3.443
Authors: Simeon Springer; Yuxuan Wang; Marco Dal Molin; David L Masica; Yuchen Jiao; Isaac Kinde; Amanda Blackford; Siva P Raman; Christopher L Wolfgang; Tyler Tomita; Noushin Niknafs; Christopher Douville; Janine Ptak; Lisa Dobbyn; Peter J Allen; David S Klimstra; Mark A Schattner; C Max Schmidt; Michele Yip-Schneider; Oscar W Cummings; Randall E Brand; Herbert J Zeh; Aatur D Singhi; Aldo Scarpa; Roberto Salvia; Giuseppe Malleo; Giuseppe Zamboni; Massimo Falconi; Jin-Young Jang; Sun-Whe Kim; Wooil Kwon; Seung-Mo Hong; Ki-Byung Song; Song Cheol Kim; Niall Swan; Jean Murphy; Justin Geoghegan; William Brugge; Carlos Fernandez-Del Castillo; Mari Mino-Kenudson; Richard Schulick; Barish H Edil; Volkan Adsay; Jorge Paulino; Jeanin van Hooft; Shinichi Yachida; Satoshi Nara; Nobuyoshi Hiraoka; Kenji Yamao; Susuma Hijioka; Schalk van der Merwe; Michael Goggins; Marcia Irene Canto; Nita Ahuja; Kenzo Hirose; Martin Makary; Matthew J Weiss; John Cameron; Meredith Pittman; James R Eshleman; Luis A Diaz; Nickolas Papadopoulos; Kenneth W Kinzler; Rachel Karchin; Ralph H Hruban; Bert Vogelstein; Anne Marie Lennon Journal: Gastroenterology Date: 2015-08-04 Impact factor: 22.682
Authors: Loes van Keimpema; Frederik Nevens; Ragna Vanslembrouck; Martijn G H van Oijen; Aswin L Hoffmann; Helena M Dekker; Robert A de Man; Joost P H Drenth Journal: Gastroenterology Date: 2009-07-29 Impact factor: 22.682