Fernandez-Rodriguez et reported a score for evaluating a patient with acromegaly and a growth hormone (GH)-secreting tumor. The authors are from Complejo Hospitalario Universitario de Santiago de Compostela in Spain.
Patient selection: acromegaly with growth-hormone secreting tumor
Parameters:
(1) pattern of cytokeratin staining on histology
(2) T2 hyperintensity on MRI
(3) age
(4) Ki-67 staining in percent
(5) baseline growth hormone and IGF-I levels
(6) tumor volume
(7) tumor size during and following therapy
Parameter
Finding
Points
pattern of cytokeratin staining
sparsely granulated
1
more densely granulated
0
T2 hyperintensity
absent
0
present
1
age
younger
2
older
0
Ki-67 staining
<= 3%
0
> 3%
2
baseline GH and IGF-I
low
0
high
2
tumor volume
small
0
large
2
tumor size following therapy
increasing
3
not increasing
0
where:
• Some findings (age, GH and IGF-I levels and tumor volume) were not given definite cutoff values.
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 13
• The higher the score the more aggressive the GH-secreting tumor.
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