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CURRENT ISSUEPANMINERVA MEDICA

A Journal on Internal Medicine


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Panminerva Medica 1999 June;41(2):157-60

 REVIEW ARTICLES

Acromegaly and intes­ti­nal neo­plasms

Scialpi C.*, Mosca S.**, Malaguti A.*, Orsi I.*, Vezzadini C.*, Toni R. * **

From the * Internal Medicine and Endocrinology Bellaria Hospital, Departments of Internal Medicine and ** Human Anatomical Sciences and Physiopathology of Locomotorium University of Bologna, Bologna, Italy

Acromegalic sub­jects ­show ­increased fre­quency of neo­plastic ­lesions in the ­colon and ­rectum ­with ­respect to the gen­eral pop­u­la­tion. Recent pros­pec­tive ­studies ­using colo­nos­copy ­have ­shown a 3 ­time ­higher prevalence of intes­tinal ­polyps and up to 4 ­time ­increased pres­ence of colo­rectal ­cancer in acrom­e­galy, inde­pen­dently of sex, age, dura­tion of dis­ease and clin­ical ­status of the ­patients. The ­polyps are dis­trib­uted ­throughout the exten­sion of the ­large ­bowel and are ­often mul­tiple, ­showing at ­least two dif­ferent his­to­logic ­types: hyper­plastic and ade­nom­a­tous. Sometimes ­they are asso­ciated ­with intes­tinal car­ci­nomas. Pancolonoscopy is the pro­ce­dure of ­choice for the diag­nosis of ­large ­bowel neo­plasms, ­even ­though it may be dif­fi­cult to com­plete in ­these sub­jects ­because of the fre­quent pres­ence of an ­enlarged and elon­gated ­colon. It ­shows a ­higher sen­sitivity and spec­i­ficity com­pared to ­other ­tests ­such as the ­barium ­enema, ­fecal ­occult ­blood ­test and ­serum ­levels of car­cin­oem­bryonic ­antigen. Therefore, it is rec­om­mended to fol­low up acrom­e­galic ­patients ­using pan­co­lo­nos­copy to ­obtain ­early detec­tion of neo­plastic ­lesions in the ­large ­bowel.

language: English


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