4.3 Article

Follow, consider, and catch: second primary tumors in acromegaly patients

Journal

ENDOCRINE
Volume 80, Issue 1, Pages 160-173

Publisher

SPRINGER
DOI: 10.1007/s12020-022-03282-7

Keywords

Acromegaly; cancer; neoplasms; second primary; multiple primaries; prevalence

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The aim of this study was to determine the prevalence of patients with two primary tumors among acromegalic cancer patients and to evaluate if patients with two primaries have distinct clinical characteristics or risk factors compared to those with one. The study revealed a 14% prevalence of two primary neoplasms in acromegalic cancer patients, with papillary thyroid carcinoma being the most common tumor.
Background and aimThe risk of second primary tumors is increased in general cancer population, however, there is no data on acromegalic cancer patients in this regard. The aim of this study is to determine the prevalence of patients with two primary tumors among acromegalic cancer patients and to evaluate if patients with two primaries have distinct clinical characteristics or risk factors compared to those with one. MethodsThis is a single-center retrospective cohort study. The study included 63 patients with at least one malignant tumor out of a total number of 394 acromegaly patients. Patients with multiple primary neoplasms were evaluated in detail. ResultsThis study revealed a 16% cancer prevalence in acromegaly patients, with 14% (9/63) having two primary neoplasms. Papillary thyroid carcinoma was the most prevalent tumor in the entire cancer cohort (41%, 26/63), and in the group of patients with two primaries (44%, 4/9). Patients with two primary tumors were older than those with one when diagnosed with acromegaly (48.3 & PLUSMN; 16.6 vs. 43.3 & PLUSMN; 10.7 years), which might be attributed to a longer diagnostic delay (median of 4.5 vs. 2 years). The period between the onset of acromegaly symptoms and diagnosis was not associated with earlier cancer diagnosis. No relationship between circulating GH or IGF-I levels and the number of neoplasms was found. ConclusionThe development of second primary tumors in acromegalic patients with cancer diagnosis is not rare. Acromegalic cancer patients should be closely monitored for new symptoms or signs that could be associated with second primary tumors.

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