Primary Therapy of Acromegaly with Octreotide LAR-A Case Report

Abstract

Traditionally, the first line treatment for acromegaly caused by growth hormone (GH) secreting pituitary adenoma is transsphenoidal surgery. However, adjuvant radiotherapy or medical therapy has been applied when necessary, and complications of hypopituitarism may occur occasionally, requiring life-long hormone replacement therapy. In recent years, there is an increasing number of studies demonstrating that medical therapy with somatostatin analogues can be employed as the primary therapy in acromegalic patients with a successful outcome. We report a patient with GH secreting pituitary adenoma causing acromegaly treated primarily with somatostatin analogues, octreotide LAR. A 52-year-old woman had progressive enlarged and swollen hands and feet with joint pain and paresthesia for 2 years. Elevated GH and insulin-like growth factor-I (IGF-I) levels were noted. The magnetic resonance image (MRI) revealed a pituitary microadenoma. She was treated primarily with octreotide LAR 20-30 mg/month for one year. The symptoms of acromegaly ameliorated, her serum GH and IGF-I declined significantly and the post-treatment MRI showed disappearance of the adenoma after octreotide LAR therapy. Adverse effects were minimal and tolerable during the treatment period. While neurosurgery remains the treatment of choice for acromegaly, the use of octreotide LAR as primary therapy in acromegaly showed to be clinically and biochemically effective in selected patients.