Curative Result with Primary Medical Therapy in an Elderly Acromegaly Patient

In acromegaly, transsphenoidal hypophysectomy is the primary treatment of choice. Medical treatment is performed on patients uncontrollable with surgery. Indications for primary medical treatment or medical treatment prior to surgery are limited to patients with macroadenoma with high risk for surge...

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Main Authors: Soner Cander, Ozen Oz Gul, Canan Ersoy, Erdinc Erturk
Format: Article
Language:English
Published: Society of Turaz Bilim 2014-12-01
Series:Medicine Science
Subjects:
Online Access:http://www.ejmanager.com/fulltextpdf.php?mno=157608
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author Soner Cander
Ozen Oz Gul
Canan Ersoy
Erdinc Erturk
author_facet Soner Cander
Ozen Oz Gul
Canan Ersoy
Erdinc Erturk
author_sort Soner Cander
collection DOAJ
description In acromegaly, transsphenoidal hypophysectomy is the primary treatment of choice. Medical treatment is performed on patients uncontrollable with surgery. Indications for primary medical treatment or medical treatment prior to surgery are limited to patients with macroadenoma with high risk for surgery due to cardiac and respiratory problems. Medical treatment is not applied on patients with microadenoma due to the high chance of cure with surgical option. Seventy-five years-old female patient was admitted in our clinic with complaints of drowsiness, fatigue and growth in hands and feet. Patients IGF1level was measured 516 ng/ml (64-118 ng/ml normal range for age and gender) and in the magnetic resonance imaging of the pituitary; an adenoma, 2x2 mm in size, was detected. Octreotide LAR therapy was begun 10 mg per month considering the age of the patient. IGF1 level was measured as 129ng/ml and growth hormone (GH) as 0.65ng/ml (0.06-5 ng/ml normal range) at the end of the third month of treatment. On the MRI carried out in the 9th month of treatment, it was observed that the pituitary was compatible with partial empty sella and no adenoma was determined. In our case of acromegaly with microadenoma, taking into account the age and medical condition of the patient, primary medical therapy was required. Although a low dose of octreotide LAR was implemented, primary medical therapy has been effective in controlling biochemical parameters. Moreover, it was observed that the tumor completely disappeared and is considered a curative result. Therefore, primary medical treatment of acromegaly should be among the options in selected patients with microadenomas. [Med-Science 2014; 3(4.000): 1697-707]
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spelling doaj.art-2bc355ee9f8f444a95ad817bc859e00b2024-02-03T08:38:23ZengSociety of Turaz BilimMedicine Science2147-06342014-12-0134169770710.5455/medscience.2014.03.8167157608Curative Result with Primary Medical Therapy in an Elderly Acromegaly PatientSoner Cander0Ozen Oz Gul1Canan Ersoy2Erdinc Erturk3Sevket Yilmaz Training and Research Hospital, Bursa, Turkey Sevket Yilmaz Training and Research Hospital, Bursa, Turkey Uludag University Medical School, Bursa, Turkey Uludag University Medical School, Bursa, TurkeyIn acromegaly, transsphenoidal hypophysectomy is the primary treatment of choice. Medical treatment is performed on patients uncontrollable with surgery. Indications for primary medical treatment or medical treatment prior to surgery are limited to patients with macroadenoma with high risk for surgery due to cardiac and respiratory problems. Medical treatment is not applied on patients with microadenoma due to the high chance of cure with surgical option. Seventy-five years-old female patient was admitted in our clinic with complaints of drowsiness, fatigue and growth in hands and feet. Patients IGF1level was measured 516 ng/ml (64-118 ng/ml normal range for age and gender) and in the magnetic resonance imaging of the pituitary; an adenoma, 2x2 mm in size, was detected. Octreotide LAR therapy was begun 10 mg per month considering the age of the patient. IGF1 level was measured as 129ng/ml and growth hormone (GH) as 0.65ng/ml (0.06-5 ng/ml normal range) at the end of the third month of treatment. On the MRI carried out in the 9th month of treatment, it was observed that the pituitary was compatible with partial empty sella and no adenoma was determined. In our case of acromegaly with microadenoma, taking into account the age and medical condition of the patient, primary medical therapy was required. Although a low dose of octreotide LAR was implemented, primary medical therapy has been effective in controlling biochemical parameters. Moreover, it was observed that the tumor completely disappeared and is considered a curative result. Therefore, primary medical treatment of acromegaly should be among the options in selected patients with microadenomas. [Med-Science 2014; 3(4.000): 1697-707]http://www.ejmanager.com/fulltextpdf.php?mno=157608Acromegalyprimary medical treatmentoctreotideelderly patient
spellingShingle Soner Cander
Ozen Oz Gul
Canan Ersoy
Erdinc Erturk
Curative Result with Primary Medical Therapy in an Elderly Acromegaly Patient
Medicine Science
Acromegaly
primary medical treatment
octreotide
elderly patient
title Curative Result with Primary Medical Therapy in an Elderly Acromegaly Patient
title_full Curative Result with Primary Medical Therapy in an Elderly Acromegaly Patient
title_fullStr Curative Result with Primary Medical Therapy in an Elderly Acromegaly Patient
title_full_unstemmed Curative Result with Primary Medical Therapy in an Elderly Acromegaly Patient
title_short Curative Result with Primary Medical Therapy in an Elderly Acromegaly Patient
title_sort curative result with primary medical therapy in an elderly acromegaly patient
topic Acromegaly
primary medical treatment
octreotide
elderly patient
url http://www.ejmanager.com/fulltextpdf.php?mno=157608
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AT ozenozgul curativeresultwithprimarymedicaltherapyinanelderlyacromegalypatient
AT cananersoy curativeresultwithprimarymedicaltherapyinanelderlyacromegalypatient
AT erdincerturk curativeresultwithprimarymedicaltherapyinanelderlyacromegalypatient