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1. Biermasz NR, Smit JW, Pereira AM, Frölich M, Romijn JA, Roelfsema F: Acromegaly caused by growth hormone-releasing hormone-producing tumors: long-term observational studies in three patients. Pituitary; 2007;10(3):237-49
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  • During medical treatment basal GH secretion remained (slightly) elevated and secretory regularity was decreased in 24 h blood sampling studies.
  • We did not observe development of tachyphylaxis towards the drug or radiological evidence of (growing) metastases.
  • We propose life-long suppressive therapy with somatostatin analogs in cases with persisting elevated serum GHRH concentrations after removal of the primary tumor.
  • Independent parameters of residual disease are elevated basal (nonpulsatile) GH secretion and decreased GH secretory regularity.
  • [MeSH-major] Acromegaly / etiology. Adenoma / secretion. Carcinoid Tumor / secretion. Human Growth Hormone / secretion. Lung Neoplasms / secretion. Pancreatic Neoplasms / secretion. Paraneoplastic Endocrine Syndromes / metabolism. Parathyroid Neoplasms / secretion
  • [MeSH-minor] Adult. Entropy. Female. Hormones / blood. Humans. Longitudinal Studies. Magnetic Resonance Imaging. Male. Middle Aged. Octreotide. Pituitary Gland / pathology. Positron-Emission Tomography. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 17541749.001).
  • [ISSN] 1386-341X
  • [Journal-full-title] Pituitary
  • [ISO-abbreviation] Pituitary
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Hormones; 12629-01-5 / Human Growth Hormone; RWM8CCW8GP / Octreotide
  • [Other-IDs] NLM/ PMC2045692
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2. Harms E, Siggelkow H, Buchfelder M, Saeger W, Hüfner M: [Macroadenoma of the pituitary gland with moderate hyperprolactinaemia]. Dtsch Med Wochenschr; 2003 Mar 28;128(13):667-70
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  • [Title] [Macroadenoma of the pituitary gland with moderate hyperprolactinaemia].
  • [Transliterated title] Makroadenom der Hypophyse mit mässiger Hyperprolaktinämie.
  • HISTORY AND CLINICAL FINDINGS: A 46-year-old woman was referred to the neurosurgery department for treatment of a macroadenoma of the pituitary.
  • INVESTIGATIONS: The endocrinological work-up revealed a moderately elevated prolactin level of 3133 mU/l (147 ng/ml) with intact pituitary functions.
  • She had no visual impairment and the MRI depicted a pituitary tumor with a maximal diameter of 1.9 cm and both intra- and suprasellar extension.
  • DIAGNOSIS, TREATMENT AND CLINICAL COURSE: The diagnosis of a nonfunctioning macrodenoma with functional hyperprolactinemia was made and a selective transsphenoidal adenomectomy was performed.
  • The primary histology showed a chromophobe adenoma.
  • In the meantime, because of persistent galactorrhea and elevated prolactin levels, treatment with cabergolin 0.5 mg/week was started.
  • A follow-up MRI after 3 months of treatment showed a significant shrinkage of the residual tumor.
  • CONCLUSION: This case demonstrates that the differential diagnosis of macroprolactinoma with low secretory activity and functional hyperprolactinemia is very difficult preoperatively in individual cases.
  • This is relevant because macroprolactinomas with low secretory activity can also be treated successfully with dopamine agonists.
  • We therefore suggest a drug treatment trial with dopamine agonists in all macroadenoms with hyperprolactinemia, particularly in those with prolactin levels above 2000 mU/l (100 ng/ml).
  • [MeSH-major] Hyperprolactinemia / surgery. Pituitary Neoplasms / surgery. Prolactinoma / surgery
  • [MeSH-minor] Diagnosis, Differential. Ergolines / therapeutic use. Female. Follow-Up Studies. Humans. Magnetic Resonance Imaging. Middle Aged. Neoplasm, Residual / drug therapy. Pituitary Gland / pathology. Pituitary Gland / surgery. Postoperative Complications / drug therapy

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  • (PMID = 12660899.001).
  • [ISSN] 0012-0472
  • [Journal-full-title] Deutsche medizinische Wochenschrift (1946)
  • [ISO-abbreviation] Dtsch. Med. Wochenschr.
  • [Language] ger
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Ergolines; LL60K9J05T / cabergoline
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3. Pecori Giraldi F, Andrioli M, De Marinis L, Bianchi A, Giampietro A, De Martin M, Sacco E, Scacchi M, Pontecorvi A, Cavagnini F: Significant GH deficiency after long-term cure by surgery in adult patients with Cushing's disease. Eur J Endocrinol; 2007 Feb;156(2):233-9
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  • OBJECTIVE: Impaired GH secretion usually accompanies Cushing's syndrome and a variable proportion of patients reportedly fail to recover normal GH secretion after successful treatment.
  • This wide variability is most probably due to differences in the treatment (i.e. surgery and/or radiotherapy), timing of patient re-evaluation after surgery and dynamic tests employed to challenge GH secretion, and hinders a precise assessment of risk of GH deficiency after cure.
  • The aim of the present study is to evaluate GH secretory status after long-term cure of Cushing's disease achieved by surgery alone.
  • Patients were studied 2-20 years (median 3.3 years) following remission of hypercortisolism; all patients underwent transsphenoidal surgery with the removal of an ACTH-secreting adenoma; repeat pituitary surgery for relapse was performed in two patients while bilateral adrenalectomy was necessary in two patients.
  • At the time of testing, 13 patients were still on steroid replacement therapy.
  • Studies on the clinical impact of GH deficiency and the use of GH replacement therapy seem warranted in patients cured from Cushing's disease.

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  • (PMID = 17287413.001).
  • [ISSN] 0804-4643
  • [Journal-full-title] European journal of endocrinology
  • [ISO-abbreviation] Eur. J. Endocrinol.
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone; 67763-96-6 / Insulin-Like Growth Factor I; 9034-39-3 / Growth Hormone-Releasing Hormone; 94ZLA3W45F / Arginine
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4. Drimmie FM, MacLennan AC, Nicoll JA, Simpson E, McNeill E, Donaldson MD: Gigantism due to growth hormone excess in a boy with optic glioma. Clin Endocrinol (Oxf); 2000 Oct;53(4):535-8
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  • True gigantism is rare in early childhood and is usually due to excess GH secretion from a pituitary adenoma.
  • There is no evidence of a direct secretory role for the tumour and we postulate that the tumour is affecting GH secretion through an effect on somatostatin tone.
  • Specific tumour therapy is not indicated for this patient in the absence of mass effect or visual disturbance.
  • The GH excess is being treated with somatostatin analogue (Octreotide) and as he has developed precocious puberty he is also receiving long acting GnRH analogue (Zoladex).
  • This boy appears likely to have neurofibromatosis type 1 (NF1) which raises the question of subtle GH excess in NF1 patients with tall stature.
  • [MeSH-minor] Adult. Child, Preschool. Gonadotropin-Releasing Hormone / analogs & derivatives. Goserelin / therapeutic use. Humans. Magnetic Resonance Imaging. Male. Neurofibromatosis 1 / complications. Neurofibromatosis 1 / diagnosis. Neurofibromatosis 1 / drug therapy. Octreotide / therapeutic use. Puberty, Precocious / complications. Puberty, Precocious / diagnosis. Puberty, Precocious / drug therapy. Somatostatin / analogs & derivatives

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  • (PMID = 11012581.001).
  • [ISSN] 0300-0664
  • [Journal-full-title] Clinical endocrinology
  • [ISO-abbreviation] Clin. Endocrinol. (Oxf)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] ENGLAND
  • [Chemical-registry-number] 0F65R8P09N / Goserelin; 33515-09-2 / Gonadotropin-Releasing Hormone; 51110-01-1 / Somatostatin; 9002-72-6 / Growth Hormone; RWM8CCW8GP / Octreotide
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5. Saveanu A, Gunz G, Dufour H, Caron P, Fina F, Ouafik L, Culler MD, Moreau JP, Enjalbert A, Jaquet P: Bim-23244, a somatostatin receptor subtype 2- and 5-selective analog with enhanced efficacy in suppressing growth hormone (GH) from octreotide-resistant human GH-secreting adenomas. J Clin Endocrinol Metab; 2001 Jan;86(1):140-5
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  • In addition, the SSTR5-preferring analog showed a slight additive effect when used in combination with SSTR2 preferential drugs at submaximal concentrations in octreotide partially sensitive adenomas.
  • The octreotide-sensitive GH secretory adenomas presented with a high level of both SSTR2 and SSTR5 mRNA expression [222 +/- 61 and 327 +/- 136 pg/pg glyceraldehyde-3-phosphate dehydrogenase (GAPDH), respectively].
  • [MeSH-major] Adenoma / secretion. Human Growth Hormone / antagonists & inhibitors. Human Growth Hormone / secretion. Octreotide / therapeutic use. Pituitary Neoplasms / secretion. Receptors, Somatostatin / therapeutic use. Somatostatin / analogs & derivatives
  • [MeSH-minor] Acromegaly / drug therapy. Acromegaly / metabolism. Adult. Drug Resistance. Female. Hormones / therapeutic use. Humans. Male. Middle Aged. Prolactin / secretion. RNA, Messenger / metabolism. Tumor Cells, Cultured

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  • (PMID = 11231991.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / BIM-23244; 0 / Hormones; 0 / RNA, Messenger; 0 / Receptors, Somatostatin; 0 / somatostatin receptor 2; 0 / somatostatin receptor 5; 12629-01-5 / Human Growth Hormone; 51110-01-1 / Somatostatin; 9002-62-4 / Prolactin; RWM8CCW8GP / Octreotide
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6. Donangelo I, Rodacki M, Peixoto MC, Vaisman M, Caldas NR, Gadelha MR: Dependency and analgesia related to treatment with subcutaneous octreotide in patients with growth hormone-secreting tumors. Endocr Pract; 2004 Mar-Apr;10(2):107-11
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  • [Title] Dependency and analgesia related to treatment with subcutaneous octreotide in patients with growth hormone-secreting tumors.
  • OBJECTIVE: To describe three patients diagnosed with somatotropinomas in whom the analgesic effect of octreotide was observed, along with dependency to the drug.
  • METHODS: These patients had pituitary macroadenomas treated with transphenoidal surgery and pituitary radiotherapy, and received high daily doses (>900 microg/day) of subcutaneous octreotide because of persistent high levels of growth hormone and insulin-like growth factor I (IGF-I).
  • RESULTS: Headache occurred prior to drug administration in all three cases, with relief soon after.
  • We also observed tolerance to octreotide's analgesic and anti-secretory actions (one patient), craving for the drug (two patients), withdrawal syndrome (one patient), and drug abuse (one patient).
  • CONCLUSION: Dependency syndrome may occur when high doses of octreotide are used, sometimes leading to drug abuse.
  • Tolerance to the growth hormone anti-secretory effect of the drug may encourage physicians to increase doses to levels at which drug dependency has been observed.
  • [MeSH-major] Adenoma / drug therapy. Adenoma / secretion. Antineoplastic Agents, Hormonal / adverse effects. Human Growth Hormone / secretion. Octreotide / adverse effects. Pituitary Neoplasms / drug therapy. Pituitary Neoplasms / secretion. Substance-Related Disorders
  • [MeSH-minor] Adolescent. Adult. Combined Modality Therapy. Drug Tolerance. Female. Humans. Middle Aged

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  • (PMID = 15256326.001).
  • [ISSN] 1530-891X
  • [Journal-full-title] Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
  • [ISO-abbreviation] Endocr Pract
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 12629-01-5 / Human Growth Hormone; RWM8CCW8GP / Octreotide
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7. Andersen M, Bjerre P, Schrøder HD, Edal A, Høilund-Carlsen PF, Pedersen PH, Hagen C: In vivo secretory potential and the effect of combination therapy with octreotide and cabergoline in patients with clinically non-functioning pituitary adenomas. Clin Endocrinol (Oxf); 2001 Jan;54(1):23-30
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  • [Title] In vivo secretory potential and the effect of combination therapy with octreotide and cabergoline in patients with clinically non-functioning pituitary adenomas.
  • The secretory capacity, in vivo, of clinically non-functioning pituitary adenomas may possibly predict tumour volume reduction during intensive medical therapy.
  • Ten patients (mean (range) 53 years (26-73)) with clinically non-functioning macroadenomas, > or = 10 mm were studied.
  • The secretory capacity of the adenomas was examined using basal, NaCl and TRH-stimulated LH, FSH and alpha-subunit levels.
  • The effect on tumour volume of 6 months' therapy with the combination of a somatostatin analogue, octreotide 200 microg x 3/day and a dopamine-D2-agonist, cabergoline 0.5 mg x 1/day was studied.
  • The basal LH, FSH and alpha-subunit levels were determined before and during 6 months' therapy with octreotide and cabergoline, and MR scans were used to evaluate tumour volume before and during this period of therapy.
  • A reduction in tumour volume (mean +/- SEM (range); 30% +/- 4% (18-46%)) during 6 months of combination therapy with octreotide and cabergoline was recorded only in patients with in vivo secretory potential.
  • Of the six patients with pretherapy secretory capacity, one displayed a very high basal level of alpha-subunit (74 microg/l) despite unmeasurable levels of LH and TSH, and an FSH-level of 1 IU/l.
  • During six months of therapy with octreotide and cabergoline, the basal levels of LH, FSH and alpha-subunit were reduced by > or = 50% in seven patients - including the six patients with in vivo secretion prior to therapy.
  • No new visual field defects were detected during therapy and no deterioration of existing visual field defects was recorded.
  • The medical therapy was well tolerated.
  • The in vivo basal and TRH-stimulated secretory capacity of LH, FSH and alpha-subunit predicted tumour reduction following intensive medical therapy in all of our patients with non-functioning pituitary adenomas.
  • [MeSH-major] Adenoma / drug therapy. Adenoma / secretion. Antineoplastic Agents, Hormonal / therapeutic use. Pituitary Neoplasms / drug therapy. Pituitary Neoplasms / secretion
  • [MeSH-minor] Adult. Aged. Dopamine Agonists / therapeutic use. Drug Therapy, Combination. Ergolines / therapeutic use. Female. Follicle Stimulating Hormone / blood. Humans. Luteinizing Hormone / blood. Male. Middle Aged. Octreotide / therapeutic use. Prognosis. Thyrotropin / blood

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  • (PMID = 11167922.001).
  • [ISSN] 0300-0664
  • [Journal-full-title] Clinical endocrinology
  • [ISO-abbreviation] Clin. Endocrinol. (Oxf)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Dopamine Agonists; 0 / Ergolines; 9002-67-9 / Luteinizing Hormone; 9002-68-0 / Follicle Stimulating Hormone; 9002-71-5 / Thyrotropin; LL60K9J05T / cabergoline; RWM8CCW8GP / Octreotide
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8. Losa M, Mortini P, Giovanelli M: [The role of somatostatin analogues in the treatment of hypophyseal adenomas]. Minerva Endocrinol; 2003 Mar;28(1):39-51
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  • [Title] [The role of somatostatin analogues in the treatment of hypophyseal adenomas].
  • Somatostatin analogues are widely employed in the treatment of hypophyseal adenomas.
  • The most widely used analogues at the present time are octreotide and lanreotide.
  • Both octreotide and lanreotide have proved their effectiveness in the treatment of GH- and TSH-secretory hypophyseal adenomas.
  • In those patients who respond to pharmacological treatment we often achieve not only the control of hormonal hypersecretion, but also a reduction in the volume of hypophyseal neoplasia.
  • In the other types of hypophyseal adenoma, on the other hand, somatostatin analogues have proved to have little effect: apart from isolated cases of effectiveness in non-functioning adenomas, the administration both of octreotide and lanreotide to patients with Cushing's disease or prolactinoma did not significantly modify the hormonal hypersecretion or tumoural volume.
  • The side-effects of somatostatin analogues are comparatively rare and of moderate entity: only a small percentage of patients requires the treatment to be suspended owing to the occurrence of side-effects.
  • Octreotide, bound to radioactive substances or to toxins, has also been utilised for the selective destruction of neoplastic tissues expressing the sst(2) receptor of somatostatin.
  • [MeSH-major] Adenoma / drug therapy. Antineoplastic Agents, Hormonal / therapeutic use. Pituitary Neoplasms / drug therapy. Somatostatin / analogs & derivatives
  • [MeSH-minor] Acromegaly / drug therapy. Acromegaly / etiology. Adrenocorticotropic Hormone / secretion. Combined Modality Therapy. Cushing Syndrome / drug therapy. Cushing Syndrome / etiology. Forecasting. Human Growth Hormone / secretion. Humans. Insulin-Like Growth Factor I / secretion. Octreotide / adverse effects. Octreotide / pharmacology. Octreotide / therapeutic use. Peptides, Cyclic / adverse effects. Peptides, Cyclic / pharmacology. Peptides, Cyclic / therapeutic use. Prolactinoma / drug therapy. Radiopharmaceuticals / therapeutic use. Receptors, Somatostatin / drug effects. Receptors, Somatostatin / physiology. Thyrotropin / secretion. Treatment Outcome. Yttrium Radioisotopes / therapeutic use

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  • (PMID = 12621362.001).
  • [ISSN] 0391-1977
  • [Journal-full-title] Minerva endocrinologica
  • [ISO-abbreviation] Minerva Endocrinol.
  • [Language] ita
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Peptides, Cyclic; 0 / Radiopharmaceuticals; 0 / Receptors, Somatostatin; 0 / Yttrium Radioisotopes; 118992-92-0 / lanreotide; 12629-01-5 / Human Growth Hormone; 51110-01-1 / Somatostatin; 67763-96-6 / Insulin-Like Growth Factor I; 9002-60-2 / Adrenocorticotropic Hormone; 9002-71-5 / Thyrotropin; RWM8CCW8GP / Octreotide
  • [Number-of-references] 79
  •  go-up   go-down


9. Daems T, Verhelst J, Michotte A, Abrams P, De Ridder D, Abs R: Modification of hormonal secretion in clinically silent pituitary adenomas. Pituitary; 2009;12(1):80-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Modification of hormonal secretion in clinically silent pituitary adenomas.
  • BACKGROUND: Silent pituitary adenomas are a subtype of adenomas characterized by positive immunoreactivity for one or more hormones classically secreted by normal pituitary cells but without clinical expression, although in some occasions enhanced or changed secretory activity can develop over time.
  • PATIENTS AND METHODS: A series of about 500 pituitary adenomas seen over a period of 20 years were screened for modification in hormonal secretion.
  • RESULTS: Two cases were retrieved, one silent somatotroph adenoma and one thyrotroph adenoma, both without specific clinical features or biochemical abnormalities, which presented 20 years after initial surgery with evidence of acromegaly and hyperthyroidism, respectively.
  • While the acromegaly was controlled by a combination of somatostatin analogs and growth hormone (GH) receptor antagonist therapy, neurosurgery was necessary to manage the thyrotroph adenoma.
  • Immunohistochemical examination demonstrated an increase in the number of thyroid stimulating hormone (TSH)-immunoreactive cells compared to the first tissue.
  • Apparently, the mechanisms responsible for the secretory modifications are different, being a change in secretory capacity in the silent somatotroph adenoma and a quantitative change in the silent thyrotroph adenoma.
  • CONCLUSIONS: These two cases, one somatotroph and one thyrotroph adenoma, are an illustration that clinically silent pituitary adenomas may in rare circumstances evolve over time and become active, as previously demonstrated in silent corticotroph adenomas.
  • [MeSH-major] Pituitary Neoplasms / metabolism
  • [MeSH-minor] Acromegaly / drug therapy. Acromegaly / metabolism. Acromegaly / surgery. Adult. Human Growth Hormone / secretion. Humans. Immunohistochemistry. Insulin-Like Growth Factor I / secretion. Male. Thyrotropin / secretion

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  • (PMID = 18350381.001).
  • [ISSN] 1573-7403
  • [Journal-full-title] Pituitary
  • [ISO-abbreviation] Pituitary
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone; 67763-96-6 / Insulin-Like Growth Factor I; 9002-71-5 / Thyrotropin
  • [Number-of-references] 30
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