title: Acromegaly and anaplastic astrocytoma: coincidence or pathophysiological relation?
abstract: Insulin-like growth factor type I (IGF-I) is an important promoter in the tumorigenesis of several extracranial and intracranial neoplasms. In astrocytic-cell tumors, the role of autocrine and paracrine IGF-I expression in enhancing tumoral progression is well established. However, the influence of systemic IGF-I levels on the clinical behavior of astrocytic neoplasms remains an open subject of research. We report the case of a 28-year-old man who presented simultaneously with acromegaly and an anaplastic astrocytoma, which had rapidly progressed from a low-grade astrocytoma. The coexistence of systemic IGF-I hypersecretion with a quick progression in the histopathological grade of the astrocytoma raises the compelling question of whether the clinical behavior of the astrocytic tumor was influenced by the acromegalic status. The role of IGF-I signaling in the pathogenesis of astrocytic-cell tumors and the experience with therapeutic strategies addressing this pathway in astrocytomas are also discussed.
authors.affiliation: Endocrinology Department, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Old Road, Headington, Oxford, OX3 7LE, UK.
authors.forename: Alberto
authors.initials: A
authors.lastname: Fernandez
authors.forename: Niki
authors.initials: N
authors.lastname: Karavitaki
authors.forename: Olaf
authors.initials: O
authors.lastname: Ansorge
authors.forename: Violet
authors.initials: V
authors.lastname: Fazal-Sanderson
authors.forename: John A H
authors.initials: JA
authors.lastname: Wass
mesh_terms: D000172:Acromegaly / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology; D000328:Adult; D001254:Astrocytoma / Q000150:complications* / Q000378:metabolism / Q000473:pathology / Q000628:therapy; D001932:Brain Neoplasms / Q000150:complications* / Q000378:metabolism / Q000473:pathology / Q000628:therapy; D000077465:Cabergoline; D016371:Cranial Irradiation; D003399:Craniotomy; D018450:Disease Progression; D004873:Ergolines / Q000627:therapeutic use; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D008297:Male; D009367:Neoplasm Staging; D010456:Peptides, Cyclic / Q000627:therapeutic use; D013004:Somatostatin / Q000031:analogs & derivatives / Q000627:therapeutic use; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D004873:Ergolines; D010456:Peptides, Cyclic; C060347:lanreotide; D013004:Somatostatin; D007334:Insulin-Like Growth Factor I; D000077465:Cabergoline