Transformation of a MGUS to overt multiple myeloma: the possible role of a pituitary macroadenoma secreting high levels of insulin-like growth factor 1 (IGF-1).
We present a female patient with monoclonal gammopathy of undetermined significance who has remained stable for five years but evolved to overt myeloma in strict temporal relationship with the diagnosis of GH-secreting pituitary macroadenoma. IGF-I serum levels correlated with serum and urine M component. Since the in vitro role of IGF-I on proliferation and survival of normal and neoplastic plasma cells has been recently emphasized, the pathogenetic link between acromegaly and transformation of gammopathy to overt myeloma in this case is discussed.
Tucci
Alessandra
A
Sezione di Ematologia, Spedali Civili, P.le Spedali Civili 1, 25125 Brescia, Italy.
Bonadonna
Stefania
S
Cattaneo
Chiara
C
Ungari
Marco
M
Giustina
Andrea
A
Guiseppe
Rossi
R
D000236:Adenoma / Q000188:drug therapy / Q000378:metabolism* / Q000532:radiotherapy; D000368:Aged; D002470:Cell Survival; D003131:Combined Modality Therapy; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D019382:Human Growth Hormone / Q000378:metabolism; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D009101:Multiple Myeloma / Q000209:etiology*; D009194:Myeloma Proteins / Q000032:analysis; D009378:Neoplasms, Multiple Primary; D015282:Octreotide / Q000627:therapeutic use; D010265:Paraproteinemias / Q000150:complications*; D010456:Peptides, Cyclic / Q000627:therapeutic use; D010911:Pituitary Neoplasms / Q000188:drug therapy / Q000378:metabolism* / Q000532:radiotherapy; D010950:Plasma Cells / Q000473:pathology; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000627:therapeutic use
D009194:Myeloma Proteins; D010456:Peptides, Cyclic; C060347:lanreotide; D019382:Human Growth Hormone; D013004:Somatostatin; D007334:Insulin-Like Growth Factor I; D015282:Octreotide