Session: MON 306-326-Neoplasia of Endocrine Tissues: Case Reports
Poster Board MON-308
Clinical Case: A 43-year-old man showed symptoms of hypoglycemia and difficulty in urination. He was working for a period of 5 years with an electric transformer or converter. For a not evident reason the patient was on treatment with betamethasone for two years. Patient had facial skin lesions, acromegaly like features and bilateral gynecomastia. Fasting blood glucose ranging in 30-45 mg / dL. Albumin: 2.9 g/ L (3.5-5.0), TSH: 1.43 mU / L; FT4: 1.2 ug / L; Prolactin 8.41 mg / dL; Cortisol/24h 588.80 mcg/24h (55-286). 4600.00 ml volume; ACTH: 29.9 (0-46). F Testosterone: 5.98 pg / mL (7.2-23); LH: 2.2 mIU / mL (1.7-8.6); FSH: 2.2 mIU / mL (1.5-12.4); Estradiol: 49.73 (7.6-42.6); DHES: 2.3.
A reduction of IGFBP3: 1880 ng/ml (3300-6600); IGF-1: < 25 ng/mL (101-267); hGH: 0,1; Proinsulin: 5.6 pmol / L (<18.9); Insulin 0.20 mU/ l (2.60-24.90); C-peptide: 0.07 ng/mL (1.1-4.4) was observed with an increase in IGF-2: 756 ng / ml (55-240). An abdominal RNM showed a great 20x12x14cm pelvic mass which demonstrates diameter -occupying most of the pelvic cavity, bladder retro and left lateral displacement straight antero lateral rectus. A biopsy of the tumor showed the typical morphological features of HPC-like vessels, collagenous stroma and patternless architecture of spindled-to-ovoid tumor cells. Immunostaining for CD34 was positive in the tumor cells and in endothelial cells. Because the tumor was not considered for surgery, a chemotherapy treatment was initiated with partial reduction of symptoms of hypoglycemia and estrogen levels.
Conclusion: Epigenetic alterations may influence the origin and biochemical behaviors of HPC. A suppression of growth hormone axis because of the increase of IGF2 and elevation of aromatase activity are characteristic of some HPC
Nothing to Disclose: FL, AV, GG
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