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KMID : 0356620100250040378
Journal of Korean Society of Endocrinology
2010 Volume.25 No. 4 p.378 ~ p.381
The Effect of Octreotide LAR on GH and TSH Co-Secreting Pituitary Adenoma
Kim Nam-Keong

Hah Yu-Jin
Lee Ho-Young
Kim Sang-Jin
Kim Mi-Kyung
Park Keun-Gyu
Kim Eal-Maan
Chang Hyuk-Won
Kim Hye-Soon
Abstract
Growth hormone (GH) and thyroid stimulating hormone (TSH)-secreting pituitary adenomas are very rare and they account for only 0.5% for all pituitary adenomas. These adenomas are usually treated with surgery, but this surgery is not easy because the tumor is usually huge and invasive. We reported here on a case of a GH-TSH-secreting adenoma in a 23-year-old male patient who was initially treated with octreotide LAR. He presented with symptoms of headache, palpitation and a visual defect that he had for the 3 months. He had hypertrophy of the frontal bone and enlargement of both the hands and feet. The visual field test showed bitemporal hemianopsia. The laboratory examinations showed high serum levels of free T4, TSH and free alpha-subunit. Additionally, the serum levels of GH and insulin-like growth factor-I (IGF-I) were increased. GH was not suppressed below 1¥ìg/L by an oral 75g glucose loading test, and TSH was not stimulated by thyrotropin-releasing hormone (TRH). Because sellar MRI showed invasive macroadenoma encasing the vessels, we initially tried octreotide LAR for treatment. A year later, the IGF-I and thyroid function tests were normalized and the size of the tumor was reduced with cystic change. The symptoms of palpitation and headache were improved without a change of the visual field defect.
KEYWORD
Acromegaly, Octreotide LAR, Pituitary adenoma, TSH-secreting tumor
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