Melanoma Onset After Estrogen, Thyroid, and Growth Hormone Replacement Therapy

被引:12
作者
Caldarola, Giacomo [1 ]
Battista, Claudia [2 ]
Pellicano, Riccardo [1 ]
机构
[1] Casa Sollievo della Sofferenza Hosp, IRCCS, Dept Dermatol, I-71013 San Giovanni Rotondo, Italy
[2] Casa Sollievo della Sofferenza Hosp, IRCCS, Dept Endocrinol, I-71013 San Giovanni Rotondo, Italy
关键词
melanoma; hormonal therapy; growth hormone; estrogens; replacement therapy; thyroid hormones; MELANOCYTIC NEVI; ORAL-CONTRACEPTIVES; SKIN-CANCER; CHILDREN;
D O I
10.1016/j.clinthera.2010.01.011
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Background: Acute Sun exposure is the main risk factor for the development of melanoma, especially if associated with a large number of benign melanocytic nevi. Although epidemiologic studies have investigated the effects Of exogenous triggers, particularly hormones, our understanding of melanoma is still inadequate. Objective: The aim of this study was to report a case of melanoma that developed after hormonal therapy. Case summary: We report a case of a 26-year-old white woman (weight, 48 kg; Fitzpatrick skin phototype IV; no previous pregnancy) who was referred to the Department of Dermatology, Casa Sollievo della Sofferenza Hospital-IRCCS, San Giovanni Rotondo, Italy, with a malignant melanoma on the left thigh. At the age of 18 years (year 2000), the patient presented with amenorrhea, but no therapy was initiated until 2004. At this time, insufficiency of the gonadal, thyroid, and growth hormone (GH) axes was diagnosed without evidence of hypothalamic-pituitary anatomic damage or of congenital or acquired causes. The patient had an inadequate level of GH (base: 0.8 g/mL; peak: 1.0 ng/rnL) during all Insulin tolerance test, low levels of thyroid hormones, and a blunted response of luteinizing hormone (base: 0.2 mlU/mL; peak: 10 Il1lU/rnL) and follicle-stimulating hormone (base: 2.6 mlU/mL; peak: 18.5 mIU/mL) to a gonadotrophin-releasing hormone stimulation test. Consequently, replacement therapy with ethinyl estradiol (20 mu g) Plus progestin (75 mu g) (once daily for 21 days/month), levothyroxine (25 mu g once daily), and recombinant human GH (0.8 mg SC once daily) was initiated. GH replacement therapy was discontinued after 2 years (June 2006), and thyroid and estrogen replacement therapy were discontinued after 4 years (February 2008). The patient reported first noticing the pigmented lesion S months after GH withdrawal, during treatment with the estrogen/progestin combination. Conclusion: We report a case of melanoma onset in a patient who had received hormonal substitutive therapy, where the role of GH therapy alone or In combination with other hormones could not lie ruled out. (Clin Ther. 2010;32:57-.59) (C) 2010 Excerpta Medica Inc.
引用
收藏
页码:57 / 59
页数:3
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