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Clinical Cases in mineral and bone metabolism

Coexistence of torus palatinus and acromegaly, an association with a common origin

Case report, 103 - 106
doi: 10.11138/ccmbm/2018.15.1.103
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Abstract
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Introduction. Acromegaly is an uncommon pathology, with insidious symptoms that conduce to late diagnosis.
Some clinical signs are present in these patients with a relative frequency, such as exostoses. It was possible identify a large and high density oral exostosis, torus palatinus type in a patient with acromegaly, which constitutes a finding that until now has not been described in this pathology.
Case presentation. It is about a female patient mestizo/Hispanic, of 44 years old, who was simultaneously diagnosed with acromegaly and identification of a solid lesion on the midline of the hard palate. Through diagnostic images and clinics features, diagnosis of a torus palatinus was made. Later, we found in this patient a pituitary macroadenoma. Transsphenoidal resection was performed and medical management with somatostatin analogue was initiated, because tumoral recurrence and persistence of musculoskeletal
symptoms, accompanied by high plasma level of Somatomedin C and growth hormone.
Discussion. The early treatment of acromegaly is limited by precociously of pathology diagnosis. We propose the inspection of oral cavity, searching oral exostoses like torus palatinus, to create a clinical suspicion in patients with phenotypic features compatible with acromegaly.

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    doi: 10.11138/ccmbm/2018.15.1.103
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