title: Insulin-like growth factor-1 is essential to the increased mortality caused by excess growth hormone: a case of thyroid cancer and non-Hodgkin's lymphoma in a patient with pituitary acromegaly.
abstract: The effects of growth hormone are mediated in part by stimulating the production of insulin-like growth factor-1. Insulin-like growth factor-1 has significant effects on cell proliferation and differentiation, it is a potent mitogen, and it is a powerful inhibitor of programmed cell death (apoptosis). Insulin-like growth factor-1 also has a well-established role in the transformation of normal cells to malignant cells. Case reports on a possible association between elevated growth hormone and cancer risk in a variety of patient groups have been published. Here, we describe clinical and laboratory findings for a patient with acromegaly who first developed thyroid cancer, and then, in the follow up period, probably due to poorly controlled insulin-like growth factor-1 levels, developed a large cell non-Hodgkin's lymphoma. A search revealed that a case with these peculiarities had not previously been reported.
authors.affiliation: Department of Internal Medicine, Division of Endocrinology and Metabolism, Gulhane Military Medical Faculty, 06018 Ankara, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Taslipinar
authors.forename: E
authors.initials: E
authors.lastname: Bolu
authors.forename: L
authors.initials: L
authors.lastname: Kebapcilar
authors.forename: M
authors.initials: M
authors.lastname: Sahin
authors.forename: G
authors.initials: G
authors.lastname: Uckaya
authors.forename: M
authors.initials: M
authors.lastname: Kutlu
mesh_terms: D000172:Acromegaly / Q000188:drug therapy / Q000209:etiology; D000236:Adenoma / Q000150:complications / Q000378:metabolism* / Q000601:surgery; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000077465:Cabergoline; D003520:Cyclophosphamide / Q000627:therapeutic use; D004873:Ergolines / Q000627:therapeutic use; D019382:Human Growth Hormone / Q000031:analogs & derivatives / Q000378:metabolism / Q000627:therapeutic use; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000378:metabolism*; D008297:Male; D009378:Neoplasms, Multiple Primary; D015282:Octreotide / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D013964:Thyroid Neoplasms / Q000150:complications / Q000378:metabolism* / Q000601:surgery; D013965:Thyroidectomy; D013974:Thyroxine / Q000627:therapeutic use; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D018931:Antineoplastic Agents, Hormonal; D004873:Ergolines; D019382:Human Growth Hormone; D014750:Vincristine; D007334:Insulin-Like Growth Factor I; D003520:Cyclophosphamide; D000077465:Cabergoline; C406545:pegvisomant; D013974:Thyroxine; D015282:Octreotide; D011241:Prednisone