Acromegaly and diffuse multinodular goiter: clinical cases

Background. Acromegaly is a severe neuroendocrine disease associated with increased production of growth hormone by cells of the adenohypophysis. Many authors have shown that the thyroid pathology in patients with pituitary adenomas producing somatotropic hormone (STH) occurs more often than the population, and mixed (diffuse-nodular or diffuse-multinodular) goiter is the most common thyroid disease. A series of clinical cases. In the available literature, we did not find a description of the development of a goiter with airway obstruction and pronounced dislocation of the neck organs in patients with acromegaly, and therefore we present two clinical cases of giant diffuse multinodular goiter against the background of prolonged growth hormone hyperproduction. In the presented cases, the continued growth of the thyroid gland against the background of acromegaly was associated with the patients’ lack of compliance and refusal of both neurosurgical and conservative treatment. Conclusion. Currently, thyroid pathology is not included in a number of clinical manifestations of acromegaly, and therefore there are no recommendations for appropriate screening of such patients. Patients with STH-producing pituitary adenomas are at risk of developing giant multinodular goiter with the further development of life-threatening tracheal stenosis. This fact can serve as a sufficient reason for ultrasound examination of the thyroid gland in patients with somatotropinomas already at the stage of primary diagnosis of the disease. Timely treatment of STH-producing tumors of the pituitary gland will eliminate the effect of growth hormone on nodulation and an increase in the thyroid gland volume and, accordingly, avoid compression of the neck organs.

acromegaly, pituitary adenoma, somatotropinoma, thyroid gland, nodular goiter, multinodular goiter, clinical case