Gordon Murray B, Nakhle Samer, Ludlam William H
Allegheny Neuroendocrinology Center, Departments of Medicine and Neurosurgery, Allegheny General Hospital, 320 East North Avenue, Pittsburgh, PA 15212, USA.
Palm Research Center, 9280 West Sunset Road, Suite 306, Las Vegas, NV 89148, USA.
Case Rep Endocrinol. 2016;2016:5156295. doi: 10.1155/2016/5156295. Epub 2016 Nov 29.
. Frequent colonoscopy screenings are critical for early diagnosis of colon cancer in patients with acromegaly. . We performed a retrospective analysis of the incidental diagnoses of colon cancer from the ACCESS trial (ClinicalTrials.gov identifier: NCT01995734). Colon cancer was identified in 2 patients (4.5%). Case 1 patient was a 36-year-old male with acromegaly who underwent transsphenoidal surgery to remove the pituitary adenoma. After surgery, the patient underwent routine colonoscopy screening, which revealed a 40 mm tubular adenoma in the descending colon. A T1N1a carcinoma was surgically removed, and 1 of 22 lymph nodes was positive for metastatic disease, leading to a diagnosis of stage 3 colon cancer. Case 2 patient was a 50-year-old male with acromegaly who underwent transsphenoidal surgery to remove a 2 cm pituitary adenoma. The patient reported severe cramping and lower abdominal pain, and an invasive 8.1 cm grade 2 adenocarcinoma with signet rings was identified in the ascending colon and removed. Of the 37 lymph nodes, 34 were positive for the presence of tumor cells, and stage 3c colon cancer was confirmed. Current guidelines for colonoscopy screening at the time of diagnosis of acromegaly and at appropriate follow-up intervals should be followed.
频繁的结肠镜检查对于肢端肥大症患者结肠癌的早期诊断至关重要。我们对ACCESS试验（ClinicalTrials.gov标识符：NCT01995734）中结肠癌的偶然诊断进行了回顾性分析。2例患者（4.5%）被确诊为结肠癌。病例1患者为一名36岁的肢端肥大症男性，接受了经蝶窦手术切除垂体腺瘤。术后，患者接受了常规结肠镜检查，结果显示降结肠有一个40毫米的管状腺瘤。手术切除了一个T1N1a期癌，22个淋巴结中有1个有转移病灶，诊断为3期结肠癌。病例2患者为一名50岁的肢端肥大症男性，接受了经蝶窦手术切除一个2厘米的垂体腺瘤。患者报告有严重绞痛和下腹部疼痛，在升结肠发现了一个8.1厘米的浸润性2级印戒腺癌并予以切除。37个淋巴结中，34个有肿瘤细胞，确诊为3c期结肠癌。应遵循目前关于肢端肥大症诊断时和适当随访间隔期结肠镜检查筛查的指南。
