Coexistence Acromegaly and Multiple Myeloma

Background Acromegaly is a slow-growing and chronic disease which increases releasing of insulin-like growth factor 1 (IGF-1) from liver. The most common reason of acromegaly is growth hormone-secreting pituitary tumor because IGF-1 has mitogenic and antiapoptotic activity which provoke growth of malignancy.

Multiple myeloma (MM) is characterized by the presence of bone marrow monoclonal plasma cells. It causes pain in the bones especially in vertebrae.

Case A 58-year-old woman referral to our clinic because of acromegaly by growth hormone-secreting pituitary tumor. She had fatigue, headache, sweating, back pain, and difficulty in walking. In cranial MRI, pituitary macroadenoma was seen. Because of symptoms such as back pain and difficulty walking, thoracic and lumbar MRI were taken, and compression fractures in T5, T6, T7, T9, and L1 were seen. We took biopsy from L1 vertebra. The result of pathology was MM. Afterward, we removed pituitary tumor, and the level of GH and IGF-1 went normal range, then we sent her to medical oncology and radiation oncology.

Results and Discussion IGF-1and GH play roles to arrange normal and malign hematopoietic stem cells. Tumor incidence is more common than normal population or other pituitary tumors in untreated acromegaly. We strongly recommend that in case of coexistence of malignancy and acromegaly, acromegaly should be treated aggressively, before malignancy treatment.