Criteria for cure in acromegaly: report of a case apparently cured in which persisting tumor was found at autopsy.
A 49-year-old man with acromegaly underwent the apparently complete removal of a pituitary microadenoma by the transsphenoidal route. There was complete remission of the biochemical abnormalities for 2 1/2 years, with basal plasma growth hormone (GH) levels of less than 1 ng/ml and normal somatomedin levels. The patient then died after the rupture of a cerebral aneurysm. Serial sections of the pituitary fossa showed persistent tumor with a volume of about 6% of the remaining normal gland. It is concluded that current endocrine tests are limited in their ability to detect residual GH-secreting tumor. Their sensitivity is likely to depend on the mass of tumor and on the GH secretion rate. Predictions of long term cure based on these tests are only tentative.
D000172:Acromegaly / Q000601:surgery*; D000236:Adenoma / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D013006:Growth Hormone / Q000097:blood*; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D010902:Pituitary Gland / Q000473:pathology; D010911:Pituitary Neoplasms / Q000473:pathology / Q000601:surgery*; D011879:Radiotherapy Dosage
D013006:Growth Hormone