Corcuff J B, Ogor C, Kerlan V, Rougier M B, Bercovichi M, Roger P
Department of Endocrinology, Hospital Haut-Lévèque, Pessac.
Clin Endocrinol (Oxf). 1997 Jul;47(1):119-21. doi: 10.1046/j.1365-2265.1997.2001010.x.
Acromegaly favours the development of extrapituitary neoplasms presumably promoted through increased GH and IGF-I levels. We describe here two patients which acromegaly and benign and malignant melanocytic tumours of the eye choroid. The first patient had a 15 year history of progressive acromegaly despite trans-sphenoidal surgery, radiation and bromocriptine therapy when she presented with melanoma of the eye and a contralateral benign melanocytic tumour. The second patient was referred with typical acromegaly. The initial fundal examination revealed a right sided benign melanocytic tumour of the choroid. Subsequent follow up of the naevi has not shown any change in the tumours after one and three years respectively. The occurrence of melanoma has not been reported in acromegaly. Increased growth of benign naevi might be expected as GH and IGF-I receptors have been described on melanocytes. As naevi may degenerate into melanomas in normal subjects and radiation therapy could trigger their transformation, we suggest that prior to irradiation, acromegalic subjects should undergo a careful ocular examination in order to assess the presence of ocular naevi.
肢端肥大症有利于垂体外肿瘤的发生，可能是通过生长激素（GH）和胰岛素样生长因子-I（IGF-I）水平升高而促进。我们在此描述两名患有肢端肥大症以及眼脉络膜良性和恶性黑素细胞肿瘤的患者。第一名患者有15年进行性肢端肥大症病史，尽管接受了经蝶窦手术、放疗和溴隐亭治疗，但她出现了眼黑色素瘤和对侧良性黑素细胞瘤。第二名患者因典型的肢端肥大症前来就诊。最初的眼底检查发现右侧脉络膜有一个良性黑素细胞瘤。随后分别对这些痣进行一年和三年的随访，肿瘤均未显示出任何变化。肢端肥大症患者中尚未有黑色素瘤发生的报道。由于已在黑素细胞上发现了GH和IGF-I受体，因此可以预期良性痣的生长会增加。由于正常受试者中的痣可能会恶变为黑色素瘤，并且放射治疗可能会引发其转变，我们建议在放疗前，肢端肥大症患者应进行仔细的眼部检查，以评估眼部痣的存在情况。
