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