Evidence of the production, by a pulmonary carcinoid tumor, of growth hormone releasing factor causing acromegaly
Gilsanz Peral, A.; Gómez Balaguer, M.; Alberola Carbonell, C.; Pastor Guillem, J.; Costa Talens, P.
Medicina Clinica 89(18): 789-792
1987
ISSN/ISBN: 0025-7753 PMID: 3123819 Document Number: 296534
Rarely, acromegaly appears as the clinical manifestation of the ectopic production of releasing factors of growth hormone (GH). We report the case of a female patient with a parotid tumour who had a clinical and biochemical picture of acromegaly. There was enlargement of the sella, but without evidence of pituitary adenoma in cerebral CT. A pulmonary tumour was suspected to correspond to a carcinoid. In addition, the serum levels of thyrotropin (TSH) were high, with normal thyroid hormones. The patient was operated on for the parotid tumour, and, subsequently, for the pulmonary carcinoid. The resection of the later was followed by the remission of the clinical features of acromegaly and normalization of GH and TSH. Using immunohistochemical methods GH and TSH activities were not detected inthe resected lung tissue. With immunoantisera against growth horomone releasing factor (GRF), the presence of immunoreactive cells to several mollecular forms of GRF (1-40 1-44 and GRF precursor) was demonstrated. This is the eleventh case in world literature showing the production of GRF by a pulmonary carcinoid tumour as the cause of acromegaly.