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Long-standing acromegaly in a patient with a pituitary adenoma not visible on MRI

100%
Kurowska M., Malicka J., Tarach J. S.
OncoReview
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2017
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vol. 7
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issue 1
32-37
EN
Introduction: Acromegaly in the course of a pituitary microadenoma or neuroendocrine GHRH-secreting tumour (GHRH, growth hormone-releasing hormone) invisible on MRI is very rare. Objective: To present the difficulties in determining the cause behind an excessive production of the growth hormone in a patient suffering from long-standing acromegaly, without a pituitary focal lesion that would be visible on MRI. Case report: The authors describe a case of a 69-year-old female with acromegaly, diagnosed 22 years earlier based on the typical somatic symptoms, and confirmed by the elevated concentration of insulin- like growth factor type 1 and lack of growth hormone suppression in the oral glucose tolerance test. The initial MRI scan (1994) had revealed a hypoechogenic 2 x 3 mm lesion in the anterior lobe of the pituitary gland, whose presence was not reported in the subsequent MRI tests. As ectopic GHRH or growth hormone secretion was suspected, a neuroendocrine tumour was searched for. The 47.7 × 54 × 35.7 mm tumour, located in the thoracic outlet, accumulating tektreotide in receptor scintigraphy, turned out to be a nodular goitre on histopathology. Due to the undetermined location of the source of growth hormone overproduction, failure to measure GHRH levels, and the patient’s lack of consent to undergo sella turcica exploration, long-acting release octreotide had been used for many years to manage the patient’s condition. Conclusion: The long-lasting and ineffective search for a neuroendocrine tumour producing GHRH or growth hormone as well as the absence of a focal lesion in the repeated MRI scans render it impossible to unequivocally determine the cause of the patient’s acromegaly, and illustrate the difficulties in discovering the source of growth hormone overproduction.
2
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Fluorescence resonance energy transfer in studies of inter-chrornophoric distances in biornolecules

100%
Lankiewicz L., Malicka J., Wiczk W.
Acta Biochimica Polonica
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1997
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vol. 44
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issue 3
477-489
3
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Fluorescence decay time distribution analysis of cyclic enkephalin analogues. Influence of the solvents and configuration of amino acids in position 2 and 3 on changes in conformation

88%
Malicka J., Groth M., Czaplewski C., Liwo A., Wiczk W.
Acta Biochimica Polonica
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1999
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vol. 46
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issue 3
615-629
4
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Fluorescence decay time distribution analysis of cyclic enkephalin analogues; Influence of solvent and Leu configuration in position 5 on conformation

76%
Malicka J., Ganzynkowicz R., Groth M., Czaplewski C., Karolczak J., Liwo A., Wiczk W.
Acta Biochimica Polonica
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2001
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vol. 48
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issue 1
95-102
EN
Lifetime distribution analysis were performed to study the influence of Leu configuration in position 5 on changes of the peptide chain of cyclic analogues of enkephalins containing a fluorescence donor and acceptor in different solvents. The configuration change of Leu5 in all the analogues of enkephalins studied which contain donor-acceptor pairs has no apparent influence on Trp lifetime distributions. In contrast, there is a significant solvent effect on the shape of lifetime distribution.
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