Effects of octreotide infusion, surgery and estrogen on suppression of height increase and 20K growth hormone ratio in a girl with gigantism due to a growth hormone-secreting macroadenoma.
We treated an extremely tall 13-year-old girl with a growth hormone (GH)-secreting macroadenoma and GH levels of 120-495 ng/ml with a combination of preoperative octreotide infusion, surgery and postoperative octreotide infusion plus estrogen, which resulted in reduced tumor size prior to surgery, reduced GH levels and completely suppressed growth after surgery. 20K GH is produced by alternative splicing of 22K GH mRNA and the ratio of 20K GH to 22K GH is within a small range in the normal population and high in a GH-secreting tumor. The 20K/22K GH ratio in this patient was persistently elevated during each phase of the treatment and may serve as a sensitive index of tumor-derived GH secretion.
Minagawa
M
M
Department of Pediatrics, Chiba University School of Medicine, Chiba, Japan. minagawa@pediat3.m.chiba-u.ac.jp
Yasuda
T
T
Someya
T
T
Kohno
Y
Y
Saeki
N
N
Hashimoto
Y
Y
D000236:Adenoma / Q000378:metabolism* / Q000601:surgery; D000293:Adolescent; D001827:Body Height / Q000187:drug effects*; D004967:Estrogens / Q000627:therapeutic use*; D005260:Female; D005877:Gigantism / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D006728:Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D019382:Human Growth Hormone / Q000378:metabolism*; D006801:Humans; D007262:Infusions, Intravenous; D008279:Magnetic Resonance Imaging; D015282:Octreotide / Q000008:administration & dosage / Q000627:therapeutic use*; D010911:Pituitary Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000601:surgery
D004967:Estrogens; D006728:Hormones; D019382:Human Growth Hormone; D015282:Octreotide