Acromegaly Secondary to Ectopic Growth Hormone-Releasing Hormone Secretion From Metastatic Bronchial Carcinoid Tumor: A Case Report

Bronchial carcinoid tumors are malignant neuroendocrine tumors that typically arise from enterochromaffin cells found in the epithelial lining of the lungs. We report a case of a 62-year-old female who was diagnosed with an atypical bronchial carcinoid tumor and subsequently underwent left pneumonectomy in December 2002. A year later, the patient developed metastases to the liver, bone, and pancreas. Over the subsequent decade, she developed clinical features of acromegaly and had persistently elevated insulin-like growth factor 1 (IGF-1) levels. Further investigation of the metastatic lesions revealed ectopic production of growth hormone-releasing hormone (GHRH). The patient underwent multiple cycles of chemotherapy for her metastatic lesions. She also continues to require long-term therapy with octreotide (Sandostatin) and pegvisomant to control IGF-1 levels. This case highlights the rarity of ectopic GHRH secretion from metastatic bronchial carcinoid tumors and emphasizes the importance of long-term surveillance and multidisciplinary management.