Abstract

FISZLEJDER, León. Neoplasms in Acromegaly: Incidence in Colon Cancer. Rev. argent. endocrinol. metab. [online]. 2013, vol.50, n.3. ISSN 1851-3034.

Acromegaly can be associated with lung, breast, prostate, colon and thyroid cancers, among the most impor-tant malignancies. Colonoscopy allows for an early detection of adenomatous polyps, which are most commonly found in the descending colon. Hypersomatotrophism activates important tumorigenic mechanisms: apoptosis, increased cell proliferation and angiogenesis. These histological and structural changes may lead to the transformation of benign polyps into malignant carcinomas of the colon. Increased deoxycholic acid in the bile in acromegalic subjects can stimulate the proliferation and transformation of colonic epithelial cells. The presence of a redundant colon and the pronounced sigmoid flexure delay gastrointestinal transit, thus increasing the time of exposure to this acid. This increases the susceptibility of polyps to malignancy. From 45 to 50 % of polyps detected by colonoscopy are found in the descending colon and, in general, they are larger than 10 mm in diameter. Colon cancer affects approximately 5.5 % of subjects with acromegaly, being diagnosed at an average age of 65 years and with a history of disease longer than 5 years. These patients frequently have 3 or more skin tags. Their presence may lead to an early diagnosis of this complication. Somatostatin may affect the cell kinetics of the intestinal epithelium. Even if no considerable improvement in the tumor lesions has been viewed on colonoscopy, stabilization of tumor progression has been seen in 45 % of those patients who were treated with high doses of somatostatin analog, octreotide. Conclusion. In order to extend acromegalic patients survival, regular colonoscopy follow-up, among other measures, should be performed at appropriate intervals, since an early treatment of this disease is vital. No financial conflicts of interest exist.

Keywords : Hypersomatotropism; Megacolon; Gastrointestinal transit; Polyps; Cancer.

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