Garby L.,Federation dendo crinologie et Laboratoire Dhormonologie |
Raverot G.,Federation dendo crinologie et Laboratoire Dhormonologie |
Claustrat F.,Federation dendo crinologie et Laboratoire Dhormonologie |
Sassolas G.,Federation dendo crinologie et Laboratoire Dhormonologie |
And 2 more authors.
Correspondances en MHND | Year: 2012
Ectopic acromegaly due to a tumoral secretion ofGHRH is very rare. Clinical features are similar to that of a somatotropic adenoma but pituitary imaging is usually normal or only suspicious. GHRH measuremen t has an excellent specificity for diagnosis for a 250 ng/l threshold. The association of an endocrine tumor secreting GHRH to a microprolactinoma is possible in MEN I patients and may be misleading. In these patients, a GHRH determination is mandatory before pituitary surgery for a suspicion of mammo-somatotropic adenoma. Endocrine tumors are mainly pancreatic or bronchial carcinoids, usually large and easy to localize by TDM and somatostatin receptor scintigraphy. In case of pancreatic tumor, the patient should be systematically investigated for MEN!. Prognosis is favorable, even in metastatic forms. Surgery of the primary tumor and metastases is appropriate when feasible. Somatostatin analogs control GH hypersecretion but do not normalize GHRH secretion. GHRH determination is a good tool for follow-up after surgery.