Acromegaly with normal growth hormone levels: response to Sandostatin-LAR treatment

Pituitary. 2000 May;2(4):289-94. doi: 10.1023/a:1009965201451.

Abstract

We report a case of acromegaly with relatively low GH secretion in a patient with GH-secreting pituitary macroadenoma. The 44-year-old male patient presented with left temporal hemianopsia and characteristic acromegalic face, but had relatively low baseline and post-glucose GH levels. IGF-1 and IGFBP-1 were elevated. Transsphenoidal surgery did not achieve clinical or biochemiacl remission, and the patient still had elevated IGF-1 levels with low GH. Histological examination of the resected tumor revealed a pituitary adenoma stained weakly for GH. The patient was treated then with monthly injections of Sandostatin-LAR, with clinical improvement and suppression of IGF-I to the normal range. This is a rare case of acromegaly without elevated GH levels, and good response to treatment with somatostatin analog, as expected in classical GH-secreting pituitary adenomas.

Publication types

  • Case Reports

MeSH terms

  • Acromegaly / complications
  • Acromegaly / drug therapy*
  • Acromegaly / metabolism*
  • Acromegaly / pathology
  • Adenoma / complications
  • Adenoma / drug therapy*
  • Adenoma / metabolism
  • Adenoma / pathology
  • Adult
  • Antineoplastic Agents, Hormonal / administration & dosage
  • Antineoplastic Agents, Hormonal / pharmacology
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Human Growth Hormone / blood
  • Human Growth Hormone / metabolism*
  • Humans
  • Immunohistochemistry
  • Insulin-Like Growth Factor Binding Protein 3 / blood
  • Insulin-Like Growth Factor I / metabolism
  • Magnetic Resonance Imaging
  • Male
  • Octreotide / administration & dosage
  • Octreotide / pharmacology
  • Octreotide / therapeutic use*
  • Pituitary Neoplasms / complications
  • Pituitary Neoplasms / drug therapy*
  • Pituitary Neoplasms / metabolism
  • Pituitary Neoplasms / pathology
  • Prolactin / blood
  • Vision, Ocular / drug effects
  • Vision, Ocular / physiology

Substances

  • Antineoplastic Agents, Hormonal
  • Insulin-Like Growth Factor Binding Protein 3
  • Human Growth Hormone
  • Insulin-Like Growth Factor I
  • Prolactin
  • Octreotide