Acromegaly and intestinal neoplasms

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 intesti nal polyps and up to 4 time increased presence of colorectal cancer in acro megaly, 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 histolo gic types: hyperplastic and adenomatous, Sometimes they are associated with intestinal carcinomas. Pancolonoscopy is the procedure of choice for the d iagnosis of large bowel neoplasms, even though it may be difficult to compl ete in these subjects because of the frequent presence of an enlarged and e longated colon. It shows a higher sensitivity and specificity compared to o ther tests such as the barium enema, fecal occult blood test and serum leve ls of carcinoembryonic antigen. Therefore, it is recommended to follow up a cromegalic patients using pancolonoscopy to obtain early detection of neopl astic lesions in the large bowel.