Menopausal status and severe pathological conditions: is there a place for bone and neuroendocrine markers?
Introduction. Menopause involves skeletal losses, which may be accelerated by breast cancer and associated therapy, as aromatase inhibitors. Case presentation. A 67-year old Caucasian female underwent 2 years ago a right mastectomy for breast cancer (invasive ductal carcinoma of mucinous type; 85-9...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Amaltea Medical Publishing House
2016-12-01
|
| Series: | Romanian Journal of Medical Practice |
| Subjects: | |
| Online Access: | https://rjmp.com.ro/articles/2016.4/RJMP_2016_4_Art-11.pdf |
| Summary: | Introduction. Menopause involves skeletal losses, which may be accelerated by breast cancer and associated therapy, as aromatase inhibitors.
Case presentation. A 67-year old Caucasian female underwent 2 years ago a right mastectomy for breast cancer (invasive ductal carcinoma of mucinous type; 85-90% positive reaction of estrogen receptor). Synchronously, she presented, at computer tomography, a left adrenal hyperplasia, stationary during follow-up.
Tamoxifen was continued for two years, then a switch to anastrozole was done for the last four months. On admission, the assays showed a non-secretor adrenal pattern, with negative neuroendocrine markers, including serum serotonin. Bone profile pointed mild hypercalcemia with normal parathormone levels, as well as
bone turnover markers and 25-hydroxyvitamin D (negative imagery scan for bone metastases). Dual-Energy X-Ray Absorptiometry (DXA) revealed osteopenia with a mid deterioration of Trabecular Bone Score (TBS) at 1220. Further continuation of aromatase inhibitor is recommended, in association with vitamin D supplementation and monthly oral risendronate, good hydration and serial calcium assays.
Conclusion. Modern approach of menopausal breast cancer with aromatase inhibitors increases the speed of age-related bone loss, while detailed imagery may find otherwise unknown artefacts as non-tumour enlargement of adrenal glands. Whether neuroendocrine markers like 5-hydroxytryptamine will find a place in this particular context, apart from traditional bone indices, is still difficult to establish. |
|---|---|
| ISSN: | 1842-8258 2069-6108 |