Pituitary MRI Features in Acromegaly Resulting From Ectopic GHRH Secretion From a Neuroendocrine Tumor: Analysis of 30 Cases - Inserm - Institut national de la santé et de la recherche médicale Access content directly
Journal Articles (Data Paper) Journal of Clinical Endocrinology and Metabolism Year : 2023

Pituitary MRI Features in Acromegaly Resulting From Ectopic GHRH Secretion From a Neuroendocrine Tumor: Analysis of 30 Cases

1 Université de Liège
2 CHU-Liège - Centre Hospitalier Universitaire de Liège
3 Erasmus MC - Erasmus University Medical Center [Rotterdam]
4 Hop It - BUENOS AIRES - Hospital Italiano - BUENOS AIRES
5 AP-HP. Université Paris Saclay
6 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
7 PHYSENDO - Physiologie et physiopathologie endocriniennes
8 QMUL - Queen Mary University of London
9 A Coruña University Hospital [La Corogne, Espagne]
10 UFRJ - Universidade Federal do Rio de Janeiro [Brasil] = Federal University of Rio de Janeiro [Brazil] = Université fédérale de Rio de Janeiro [Brésil]
11 Hedi Chaker Hospital [Sfax]
12 GHE - Groupement Hospitalier Lyon-Est
13 CHN - Navarra Hospital Complex - Complejo Hospitalario de Navarra [Pamplona, Spain]
14 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
15 Centre Hospitalier Métropole Savoie [Chambéry]
16 Medizinische Klinik und Poliklinik IV
17 LMU - Ludwig-Maximilians University [Munich]
18 Wrocław Medical University
19 Hôpital Lariboisière-Fernand-Widal [APHP]
20 UCBL - Université Claude Bernard Lyon 1
21 HCL - Hospices Civils de Lyon
22 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
23 CHU Saint-Antoine [AP-HP]
24 SU FM - Sorbonne Université - Faculté de Médecine
25 CHU Angers - Centre Hospitalier Universitaire d'Angers
26 HCUV - Hospital Clinico Universitario de Valladolid [Castilla y León, Spain]
27 Service Neuroradiologie Diagnostique et Thérapeutique [CHU Toulouse]
28 AMU - Aix Marseille Université
29 USP - Universidade de São Paulo = University of São Paulo
30 CPME - Centre of Postgraduate Medical Education [Warsaw, Poland]
31 Landspitali National University Hospital of Iceland
32 CHUS - Complejo Hospitalario Universitario de Santiago de Compostela [Saint-Jacques-de-Compostelle, Espagne]
33 The Hebrew University Hadassah Medical School
Mohamed Abid
Gerald Raverot
Frederic Castinetti


Context: Ectopic acromegaly is a consequence of rare neuroendocrine tumors (NETs) that secrete GHRH. This abnormal GHRH secretion drives GH and IGF-1 excess, with a clinical presentation similar to classical pituitary acromegaly. Identifying the underlying cause for the GH hypersecretion in the setting of ectopic GHRH excess is, however, essential for proper management both of acromegaly and the NET. Owing to the rarity of NETs, the imaging characteristics of the pituitary in ectopic acromegaly have not been analyzed in depth in a large series.Objective: Characterize pituitary magnetic resonance imaging (MRI) features at baseline and after NET treatment in patients with ectopic acromegaly.Design: Multicenter, international, retrospective.Setting: Tertiary referral pituitary centers.Patients: Thirty ectopic acromegaly patients having GHRH hypersecretion.Intervention: None.Main outcome measure: MRI characteristics of pituitary gland, particularly T2-weighted signal.Results: In 30 patients with ectopic GHRH-induced acromegaly, we found that most patients had hyperplastic pituitaries. Hyperplasia was usually moderate but was occasionally subtle, with only small volume increases compared with normal ranges for age and sex. T2-weighted signal was hypointense in most patients, especially in those with hyperplastic pituitaries. After treatment of the NET, pituitary size diminished and T2-weighted signal tended to normalize.Conclusions: This comprehensive study of pituitary MRI characteristics in ectopic acromegaly underlines the utility of performing T2-weighted sequences in the MRI evaluation of patients with acromegaly as an additional tool that can help to establish the correct diagnosis.
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Dates and versions

inserm-04042292 , version 1 (24-12-2023)





Iulia Potorac, Jean-François Bonneville, Adrian F Daly, Wouter de Herder, Patricia Fainstein-Day, et al.. Pituitary MRI Features in Acromegaly Resulting From Ectopic GHRH Secretion From a Neuroendocrine Tumor: Analysis of 30 Cases. Journal of Clinical Endocrinology and Metabolism, 2023, 107 (8), pp.e3313 - e3320. ⟨10.1210/clinem/dgac274⟩. ⟨inserm-04042292⟩
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