Somatotropinoma infarction during octreotide therapy leading to bilateral cavernous sinus syndrome.
The cyclic somatostatin analog, octreotide, forms the mainstay of medical treatment for acromegaly. In addition to lowering circulating growth hormone levels and shrinking tumor size, octreotide may provide symptomatic relief of headaches associated with growth hormone secreting tumors. The majority of reported complications of octreotide therapy are gastrointestinal and metabolic. The present case illustrates the development of acute bilateral cavernous sinus syndrome with loss of eye movement bilaterally during octreotide therapy. Serial MRI examination suggest tumor infarction as the etiology. The symptoms resolved over 2 months as the tumor shrunk in size and growth hormone was dramatically reduced.
Boulis
N M
NM
Section of Neurosurgery, University of Michigan Medical Center, Ann Arbor, MI, USA. nboulis@umich.edu
Noordmans
A J
AJ
Barkan
A
A
Hassing
J
J
Chandler
W F
WF
D000010:Abducens Nerve / Q000187:drug effects; D002426:Cavernous Sinus / Q000473:pathology; D002544:Cerebral Infarction / Q000139:chemically induced*; D002648:Child; D003389:Cranial Nerve Diseases / Q000139:chemically induced* / Q000175:diagnosis; D005260:Female; D019382:Human Growth Hormone / Q000378:metabolism*; D006801:Humans; D008279:Magnetic Resonance Imaging; D015282:Octreotide / Q000009:adverse effects*; D009802:Oculomotor Nerve / Q000187:drug effects; D009886:Ophthalmoplegia / Q000139:chemically induced*; D010911:Pituitary Neoplasms / Q000139:chemically induced* / Q000378:metabolism*; D013577:Syndrome
D019382:Human Growth Hormone; D015282:Octreotide