Giant growth-hormone secreting pituitary tumour with extracranial extension.
A 19 year old female patient with typical features of acromegaly was found to have an extensive pituitary tumour with suprasellar, lateral and inferior extensions. Magnetic resonance imaging (MRI) also showed a portion of the tumour extending from the right cavernous sinus through the foramen ovale to become extracranial. Serum growth hormone (GH) was 52.6 mU/L basally and remained elevated after oral glucose, confirming the diagnosis of acromegaly. Treatment with the long-acting somatostatin analogue, octreotide, for 6 months led to a 30% reduction in tumour volume of the intracranial portion but no effect on the extracranial and sphenoidal extensions. She was subsequently treated with trans-sphenoidal surgery followed by external irradiation. The possibility of perineural spread of the tumour was considered.
Ip
T P
TP
Department of Medicine, University of Hong Kong.
Chan
F L
FL
Kung
A W
AW
Lam
K S
KS
D000172:Acromegaly / Q000209:etiology; D000236:Adenoma / Q000175:diagnosis / Q000378:metabolism*; D000328:Adult; D002426:Cavernous Sinus / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D013006:Growth Hormone / Q000378:metabolism*; D006801:Humans; D008279:Magnetic Resonance Imaging; D010902:Pituitary Gland / Q000473:pathology; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000378:metabolism*
D013006:Growth Hormone