Anabolic steroid abuse and pancreatic insulinoma
DOI:
https://doi.org/10.12775/MBS.2016.015Keywords
insulinoma, anabolic steroids, bodybuilderAbstract
Background. Anabolic steroid abuse is very common among bodybuilders and is related with a number of medical complications including tumorgenesis.
Case report. A 29-year-old male bodybuilder with one year history of abusing large doses of anabolic steroids presented with several episodes of neuroglycopenia with concomitant loss of consciousness. Results of imaging studies (USG, MRI, EUS) showed smooth-demarcated, focal solid lesion of 2cm in diameter in the body of the pancreas. The patient was characterized by Whipple's triad (hyperinsulinemia accompanied by hypoglycemia and signs of symptoms resolving upon glucose administration). No other disturbances were observed. The patient was qualified for the surgical treatment. Intraoperatively, tumor enucleation was performed. Postoperative time was complicated by pancreatic fistula that required reoperation involving Roux pancreaticojejunostomy. The pathological examination revealed encapsulated benign neuroendocrine tumor. The patient has been followed up for 3 years and remained disease free.
Conclusion. Given the widespread use anabolic steroids among bodybuilder, another potentially life-threatening tumor is highlighted. Insulinoma has not been previously reported in athletes. Bodybuilders should be aware of the serious medical risks including neuroendocrine tumors.References
Maravelias C, Dona A, Stefanidou M, et al. Adverse effects of anabolic steroids in athletes. A constant threat. Toxicology Letters, 2005; 158: 167-175.
de Herder WW, Niederle B, Scoazec JY, et al. Well differentiated pancreatic tumor/carcinoma: insulinoma. Neuroendocrinology, 2006; 84: 183-8.
Greenway BA, Duke D, Pym B, et al. The control of human pancreatic adenocarcinoma xenografts in nude mice by hormone therapy. British Journal of Surgery, 1982; 69: 595-597.
Varma V, Tariciotti L, Coldham C, et al. Preoperative localisation and surgical management of insulinoma: single centre experience. Digestive surgery, 2011; 28: 63–73.
Tucker ON, Crotty PL, Conlon KC. The management of insulinoma. The British Journal of Surgery, 2006; 93(3): 264-275.
Birzniece V. Doping in sport: effects, harm and misconceptions. Internal Medicine Journal, 2015; 45(3): 239-248.
Socas L, Zumbado M, Pérez-Luzardo O, et al. Hepatocellular adenomas associated with anabolic androgenic steroid abuse in bodybuilders: a report of two cases and a review of the literature, British Journal of Sports Medicine, 2005; 39(5): e27.
Gorayski P, Thompson CH, Subhash HS, et al. Hepatocellular carcinoma associated with recreational anabolic steroid use. British Journal of Sports Medicine, 2008; 42: 74-75.
Durczyński A, Sporny S, Szymański D, et al. Retroperitoneal ganglioneuroma in a young bodybuilder, Clinical and Experimental Medical Letters, 2010; 51(2): 155-157.
Prat J, Gray GF, Stolley PD, et al. Wilms Tumor in an Adult Associated With Androgen Abuse. JAMA, 1977; 237(21): 2322-2323.
Froehner M, Fischer R, Leike S, et al. Intratesticular leiomyosarcoma in a young man after high dose doping with Oral-Turinabol: a case report. Cancer, 1999; 86(8): 1571-5.
Martin NM, Abu Dayyeh BK, Chung RT. Anabolic steroid abuse causing recurrent hepatic adenomas and hemorrhage. World J Gastroenterol, 2008; 14(28): 4573–4575.
Kesler T, Sandhu R, Krishnamoorthy S. Hepatology: hepatocellular carcinoma in a young man secondary to androgenic anabolic steroid abuse. Journal of Gastroenterology and Hepatology, 2014; 29(11): 1852.
Solbach P, Potthoff A, Raatschen H-J, et al. Testosterone-receptor positive hepatocellular carcinoma in a 29-year old bodybuilder with a history of anabolic androgenic steroid abuse: a case report. BMC Gastroenterology, 2015; 15(1): 60.
Kosaka A, Takahashi H, Yajima Y, et al. Hepatocellular carcinoma associated with anabolic steroid therapy: report of a case and review of the Japanese literature. Journal of Gastroenterology 1996; 31(3): 450-4.
Tholouli E, Roulson JA, Byers R, et al. Littoral cell angioma of the spleen in a patient with severe aplastic anaemia. Haematologica, 2003; 88(11): ECR33.
Syed SP, Brooks DG, Haupt HM, et al. Anabolic steroids causing growth of benign tumors: androgen receptor in angiolipomas. Journal of the American Academy of Dermatology, 2007; 57(5): 899-900.
Corbishley TP, Iqbal MJ, Wilkinson ML, et al. Androgen receptor in human normal and malignant pancreatic tissue and cell lines. Cancer, 1986; 57: 1992-1995.
Okitsu K, Kanda T, Imazeki F, et al. Involvement of interleukin-6 and androgen receptor signaling in pancreatic cancer. Genes Cancer, 2010; 1: 859-867.
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