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Osteosarcoma and acromegaly: A case report and review of the litereture

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Abstract

A 72-yr-old acromegalic man, who presented with pain in the left femur, was found to have a metastatic osteosarcoma. Only three cases describing the coexistence of acromegaly and osteosarcoma have been reported by the literature. As the patient didn’t have other risk factors for osteosarcoma, the hypothesis that accelerated rate of bone turnover caused by long-term exposure to high GH and IGF-I could act as a predisposing factor in the development of this malignant bone tumor is discussed.

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References

  1. Rosenthal DI. Bone tumors. In: Goldman L, Ausiello D eds. Cecil Textbook of Medicine. 22nd ed. Philadelphia: W.B. Saunders. 2004, 1246–8.

    Google Scholar 

  2. Fuchs B, Pritchard DJ. Etiology of osteosarcoma. Clin Orthop Relat Res 2002, 397: 40–52.

    Article  PubMed  Google Scholar 

  3. Patel SR. Radiation-induced sarcoma. Curr Treat Options Oncol 2000, 1: 258–61.

    Article  CAS  PubMed  Google Scholar 

  4. Hawkins MM, Wilson LMK, Burton HS, et al. Radiotherapy, alkylating agents, and risk of bone cancer after childhood cancer. J Natl Cancer Inst 1996, 88: 270–8.

    Article  CAS  PubMed  Google Scholar 

  5. Tucker MA, D’Angio GJ, Boice JD, et al. Bone sarcomas linked to radiotherapy and chemotherapy in children. N Engl J Med 1987, 317: 588–93.

    Article  CAS  PubMed  Google Scholar 

  6. Hadjipavlou A, Lander P, Srolovitz H, Enker IP. Malignant transformation in Paget disease of bone. Cancer 1992, 70: 2802–8.

    Article  CAS  PubMed  Google Scholar 

  7. Hansen MF, Nellissery MJ, Bhatia P. Common mechanisms of osteosarcoma and Paget’s disease. J Bone Miner Res 1999, 14 (Suppl 2): 39–44.

    Article  PubMed  Google Scholar 

  8. Grimer RJ, Cannon SR, Taminiau AM, et al. Osteosarcoma over the age of forty. Eur J Cancer 2003, 39: 157–63.

    Article  CAS  PubMed  Google Scholar 

  9. Neff JR. Sarcomas of bone. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, Mckenna WG eds. Clinical Oncology. 3rd ed. Edinburgh: Elsevier. 2004, 2471–572.

    Google Scholar 

  10. Wright AD, Hill DM, Lowy C, Fraser TR. Mortality in acromegaly. Q J Med 1970, 39: 1–16.

    CAS  PubMed  Google Scholar 

  11. Alexander L, Appleton D, Hall R, WM Ross, Wilkinson R. Epidemiology of acromegaly in the Newcastle region. Clin Endocrinol (Oxf) 1980, 12: 71–9.

    Article  CAS  Google Scholar 

  12. Nabarro, JDN. Acromegaly. Clin Endocrinol (Oxf) 1987, 26: 481–512.

    Article  CAS  Google Scholar 

  13. Bengtsson B, Eden S, Ernest I, Oden A, Sjogren B. Epidemiology and long-term survival in acromegaly. A study of 166 cases diagnosed between 1955 and 1984. Acta Med Scand 1988, 223: 327–35.

    Article  CAS  PubMed  Google Scholar 

  14. Bates AS, Van’t Hoff W, Jones JM, Clayton RN. An audit of outcome of treatment in acromegaly. Q J Med 1993, 86: 293–9.

    CAS  PubMed  Google Scholar 

  15. Orme SM, Mcnally RJQ, Cartwright RA, Belchetz PE. Mortality and cancer incidence in acromegaly: a retrospective cohort study. J Clin Endocrinol Metab 1998, 83: 2730–4.

    CAS  PubMed  Google Scholar 

  16. James RA, Dymock RB. Osteosarcoma associated with acromegaly: a case report. Pathology 1976, 8: 157–9.

    Article  CAS  PubMed  Google Scholar 

  17. Mortensen A, Bojsen-Moller M, Rasmussen P. Fibrous dysplasia of the skull with acromegaly and sarcomatous transformation. Two cases with a review of the literature. J Neurooncol 1989, 7: 25–9.

    Article  CAS  PubMed  Google Scholar 

  18. Melmed S. Acromegaly. N Engl J Med 1990, 322: 966–77.

    Article  CAS  PubMed  Google Scholar 

  19. Ayuk J, Clayton RN, Holder G, Sheppard MC, Stewart PM, Bates AS. Growth hormone and pituitary radiotherapy, but not serum insulin-like growth factor-I concentrations, predict mortality in patients with acromegaly. J Clin Endocrinol Metab 2004, 89: 1613–7.

    Article  CAS  PubMed  Google Scholar 

  20. Melmed S. Acromegaly and cancer: Not a problem? J Clin Endocrinol Metab 2001, 86: 2929–34.

    Article  CAS  PubMed  Google Scholar 

  21. Baris D, Gridley G, Ron E, et al. Acromegaly and cancer risk: a cohort study in Sweden and Denmark. Cancer Causes Control 2002, 13: 395–400.

    Article  CAS  PubMed  Google Scholar 

  22. Ezzat S, Melmed S. Clinical review 18: are patients with acromegaly at increased risk for neoplasia? J Clin Endocrinol Metab 1991, 72: 245–9.

    Article  CAS  PubMed  Google Scholar 

  23. Jenkins PJ, Fairclough PD, Richards T, et al. Acromegaly, colonic polyps and carcinoma. Clin Endocrinol (Oxf) 1997, 47: 17–22.

    Article  CAS  Google Scholar 

  24. Jenkins PJ, Besser M. Acromegaly and cancer: a problem. J Clin Endocrinol Metab 2001, 86: 2935–41.

    Article  CAS  PubMed  Google Scholar 

  25. Tita P, Ambrosio MR, Scollo C, et al. High prevalence of differentiated thyroid carcinoma in acromegaly. Clin Endocrinol (Oxf) 2005, 63: 161–7.

    Article  Google Scholar 

  26. Webb SM, Casanueva F, Wass JAH. Oncological complications of excess GH in acromegaly. Pituitary 2002, 5: 21–5.

    Article  CAS  PubMed  Google Scholar 

  27. Giovannucci E. Insulin-like growth factor-I and binding protein-3 and risk of cancer. Horm Res 1999, 51 (Suppl 3): 34–41.

    Article  CAS  PubMed  Google Scholar 

  28. Rajah R, Valentinis B, Cohen P. Insulin-like growth factor (IGF)-binding protein-3 induces apoptosis and mediates the effects of transforming growth factor-β1 on programmed cell death through a p53- and IGF-independent mechanism. J Biol Chem 1997, 272: 12181–8.

    Article  CAS  PubMed  Google Scholar 

  29. Yu H, Rohan T. Role of insulin-like growth factor family in cancer development and progression. J Natl Cancer Inst 2000, 92: 1472–89.

    Article  CAS  PubMed  Google Scholar 

  30. Chan JM, Stampfer MJ, Giovannucci E, et al. Plasma insulin-like growth factor-I and prostate cancer risk: a prospective study. Science 1998, 279: 563–6.

    Article  CAS  PubMed  Google Scholar 

  31. Hankinson SE, Willtt WC, Colditz GA, et al. Circulating concentrations of insulin-like growth factor 1 and risk of breast cancer. Lancet 1998, 351: 1393–6.

    Article  CAS  PubMed  Google Scholar 

  32. Ma J, Pollak M, Giovannucci E, et al. Prospective study of colorectal cancer risk in men and plasma levels of insulin-like growth factor (IGF)-I and IGF-binding protein-3. J Natl Cancer Inst 1999, 91: 620–5.

    Article  CAS  PubMed  Google Scholar 

  33. Yu H, Spitz MR, Mistry J, Gu J, Hong WK, Wu X. Plasma levels of insulin-like growth factor-1 and lung cancer risk: a case-control analysis. J Natl Cancer Inst 1999, 91: 151–6.

    Article  CAS  PubMed  Google Scholar 

  34. Cohen P, Clemmons DR, Rosenfeld RG. Does the GH-IGF axis play a role in cancer pathogenesis? Growth Horm IGF Res 2000, 10: 297–305.

    Article  CAS  PubMed  Google Scholar 

  35. Kaplan PJ, Mohan S, Cohen P, Foster BA, Greenberg NM. The insulin-like growth factor axis and prostate cancer: lessons from the transgenic adenocarcinoma of mouse prostate (TRAMP) model. Cancer Res 1999, 59: 2203–9.

    CAS  PubMed  Google Scholar 

  36. DiGiovanni J, Kiguchi K, Anita F, et al. Deregulated expression of insulin-like growth factor 1 in prostate epithelium leads to neoplasia in transgenic mice. Proc Natl Acad Sci 2000, 97: 3455–60.

    Article  Google Scholar 

  37. McCarty MF. Up-regulation of IGF binding protein-1 as an anti-carcinogenic strategy: relevance to caloric restriction, exercise, and insulin sensitivity. Med Hypotheses 1997, 48: 297–308.

    Article  CAS  PubMed  Google Scholar 

  38. Kari FW, Dunn SE, French JE, Barrett JC. Roles of insulin-like growth factor-1 in mediating the anti-carcinogenic effects of caloric restriction. J Nutr Health Aging 1999, 3: 92–101.

    CAS  PubMed  Google Scholar 

  39. Giovannucci E. Nutrition, insulin, insulin-like growth factors and cancer. Horm Metab Res 2003, 35: 694–704.

    Article  CAS  PubMed  Google Scholar 

  40. Juul A, Main K, Blum WF, Lindholm J, Ranke MB, Skakkebaek NE. The ratio between serum levels of insulin-like growth factor (IGF)-I and the IGF binding proteins (IGFBP-1, 2 and 3) decreases with age in healthy adults and is increased in acromegalic patients. Clin Endocrinol (Oxf) 1994, 41: 85–93.

    Article  CAS  Google Scholar 

  41. Ohlsson C, Bengtsson B, Isaksson OG, Andreassen TT, Slootweg MC. Growth hormone and bone. Endocr Rev 1998, 19: 55–79.

    CAS  PubMed  Google Scholar 

  42. Colao A, Ferone D, Marzullo P, Lombardi G. Systemic complications of acromegaly: epidemiology, pathogenesis and management. Endocr Rev 2004, 25: 102–52.

    Article  CAS  PubMed  Google Scholar 

  43. Ezzat S, Melmed S, Endres D, Eyre DR, Singer FR. Biochemical assessment of bone formation and resorption in acromegaly. J Clin Endocrinol Metab 1993, 76: 1452–7.

    CAS  PubMed  Google Scholar 

  44. Ueland T, Bollerslev J, Hansen TB, et al. Increased cortical bone content of insulin-like growth factors in acromegalic patients. J Clin Endocrinol Metab 1999, 84: 123–7.

    CAS  PubMed  Google Scholar 

  45. Kappel CC, Velez-Yanguas MC, Hirschfeld S, Helman LJ. Human osteosarcoma cell lines are dependent on insulin-like growth factor-I for in vitro growth. Cancer Res 1994, 54: 2803–7.

    CAS  PubMed  Google Scholar 

  46. Rodriguez-Galindo C, Poquette CA, Daw NC, Tan M, Meyer WH, Cleveland JL. Circulating concentrations of IGF-I and IGFBP-3 are not predictive of incidence or clinical behavior of pediatric osteosarcoma. Med Pediatr Oncol 2001, 36: 605–11.

    Article  CAS  PubMed  Google Scholar 

  47. Price CH. Primary bone-forming tumors and their relationship to skeletal growth. J Bone Joint Surg BR 1958, 40B: 574–93.

    Google Scholar 

  48. Slow IN, Friedman EW. Osteogenic sarcoma arising in a pre-existing fibrous dysplasia: report of case. J Oral Surg 1971, 29: 126–9.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Endocrinology, Department of Internal Medicine, Clementino Fraga Filho University Hospital/Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

    G. A. B. Lima, E. M. S. Gomes, R. C. Nunes, L. Vieira Neto & M. R. Gadelha MD, PhD

  2. Department of Pathology, Clementino Fraga Filho University Hospital/Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

    A. P. A. V. Sieiro

  3. Division of Oncology, Department of Internal Medicine, Clementino Fraga Filho University Hospital/Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

    E. P. Brabo

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  1. G. A. B. Lima
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  2. E. M. S. Gomes
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  4. L. Vieira Neto
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Correspondence to M. R. Gadelha MD, PhD.

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Lima, G.A.B., Gomes, E.M.S., Nunes, R.C. et al. Osteosarcoma and acromegaly: A case report and review of the litereture. J Endocrinol Invest 29, 1006–1011 (2006). https://doi.org/10.1007/BF03349215

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