Resumo
The case of a patient with a rare malignancy whose incidence ranges from 0.2 to 2 / 100,000 individuals. The increase in incidence probably showed increasing changes in diagnosis. Approximately 25% of these tumors grow in the lungs and represent 2% of all lung tumors. Of all bronchial NETs, only 5% are associated with multiple type 1 endocrine neoplasms (MEN-1). According to the current WHO classification of 2015, neuroendocrine lung cancer should be classified into typical carcinoids, atypical carcinoids, large cell neuroendocrine carcinoma or small cell carcinoma, the classification being based on histological morphology. The commonly associated endocrine syndromes are inadequate secretion of the natriuretic hormone, Cushing's syndrome and, rarely, acromegaly. We report a case of a male patient with a large neuroendocrine tumor associated with a pituitary macroadenoma. Laboratory tests on admission were changed, GH of 56.5 ng / mL (Ref <5 ng / mL), IGF-1 of 1304.4 ng / mL (Ref-96.4 - 227.8 ng / mL), chromogranin 4.89 (Ref 3.00), b-HCG-negative. The patient was initially submitted to thoracic surgery and subsequently underwent neurological surgery in another center, so that he was accompanied by professionals from various areas, making it increasingly evident the need for hospitals to have centers for the study of these neuroendocrine tumors.
Referências
AKINTOYE, S. O. Pegvisomant For The Treatment Ofgsp-Mediated Growth. The Journal Of Clinical
Endocrinology & Metabolism, v. 91, n. 8, p. 2960–2966. Doi:10.1210/Jc.2005-2661.
COOPER, William A. et al. The Surgical spectrum of pulmonary neuroendocrine neoplasms. Chest, v. 119, n. 1, p. 14-8, 2001.
DOGANSEN, S. C.et al. (2018). Evaluation of the natural course of thyroid nodules in patients with acromegaly. Pituitary. v. 22, n. 1, p. 29-36, 2019. Doi:10.1007/S11102-018-0923-1.
FEROLLA, P. Medical therapy of pulmonary neuroendocrine neoplasms: targeted, symptomatic and chemotherapy. Front Horm Res. v. 44, p. 193-7, 2015.
HAWKINS, F. et al. Acromegaly and bronchial carcinoid. Effect of Removal ofthe Latter. Chest, v. 88, n. 1, p. 149-52, 1985.
KRUG, S. Acromegaly in a patient with a pulmonary neuroendocrine tumor: case report and review of current literature. BMC Res Notes. v. 27, n. 9, p. 326, 2016.
LAD, T. et al. A prospective randomized trial to determine the benefit of surgical resection of residual disease following response of small cell lung cancer to combination chemotherapy. Chest. v. 106, n. 6 suppl, p. 320S–323S, 1994.
LOCK, K. Y. et al. An unusual cause of acromegaly. Hong Kong Med J. v. 20, n. 4, p. 331-4, 2014.
MARTINI, N. et al. Treatment and prognosis in bronchial carcinoids involving regional lymph nodes. J Thorac Cardiovasc Surg 1994; 107:1–6.
MATYJASZEK-MATUSZEK, B. et al. Prevalence Of Neoplasms In Patients With Acromegaly- The Need For A National Registry. Annals of Agricultural and Environmental Medicine. v. 25, n. 3, p. 559-561, 2018.
METE, O. Synchronous multiple pituitary neuroendocrine tumors of different cell lineages.
Endocr Pathol. v. 29, n. 4, p. 332-338, 2018. doi: 10.1007/s12022-018-9545-4.
NACHTIGALL, Lisa B. Acromegaly diagnosed in a young woman presenting with headache and arthritis. Nature Clinical Practice Endocrinology &Amp Metabolism. v. 2, n. 10, p. 582-7, 2006.
SASAGAWA, Y. et al. Transphenoidal surgery for elderly patients with acromegaly and its outcomes: comparison with younger patients. World Neurosurg. v. 118, p. 229-234, 2018. doi:10.1016/J.Wneu.2018.06.165.
SAYEG, Y. et al. Neuroendokrine neoplasien der lunge pulmonary neuroendocrine neoplasms. Pneumologie v. 68, n. 7, p. 456-477, 2014.
VIEIRA NETO, L. et al. Recomendações do Departamento de Neuroendocrinologia da Sociedade Brasileira de Endocrinologia e Metabologia para o diagnóstico e tratamento da acromegalia no Brasil. Arquivos Brasileiros de Endocrinologia & Metabologia, v. 55, n. 2, p. 91–105, 2011.
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Copyright (c) 2023 Filadélfia Passos Rodrigues Martins, Leonardo Cesar Silva de Oliveira , Fabio Rocha Tavora , Vitor Camarão Porto , Gabriela Sanford Guimarães Caminha de Oliveira , Victor Sousa Martins de Alcantara Meireles