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Acromegaly from ectopic growth hormone‐releasing hormone secretion by a malignant carcinoid tumor. Successful treatment with long‐acting somatostatin analogue SMS 201–995
Author(s) -
Barkan Ariel L.,
Shenker Yoram,
Grekin Roger J.,
Vale Wylie W.
Publication year - 1988
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19880115)61:2<221::aid-cncr2820610203>3.0.co;2-3
Subject(s) - acromegaly , medicine , endocrinology , somatostatin , hormone , growth hormone–releasing hormone , octreotide , thyrotropin releasing hormone , hypophysectomy , gigantism , bromocriptine , pituitary gland , carcinoid syndrome , prolactin , growth hormone
A 26‐year‐old man with acromegaly secondary to ectopic growth hormone‐releasing hormone (GHRH) secretion by a metastatic carcinoid tumor is the subject of this study. He previously failed to respond to conventional therapeutic modalities (partial hypophysectomy, pituitary irradiation, high‐dose bromocriptine and a combination of streptozotocin and 5‐fluorouracil) and was treated with long‐acting somatostatin analogue SMS 201–995 (Sandoz, East Hanover, NJ). Growth hormone and somatomedin C concentrations became normal, and GHRH‐LI (GHRH‐like immunoreactivity) was suppressed by more than 60%. The growth hormone response to exogenous GHRH 1–40 was stopped and growth hormone rise to thyrotropin‐releasing hormone (TRH) was significantly attenuated. A significant shrinkage of the pituitary gland was observed. Similarly, the size of the metastatic carcinoid lesions decreased dramatically and was accompanied by a normalization of liver function. After almost 2 years of SMS 201–995 therapy, the patient was well and had no clinical signs of acromegaly. Thus, SMS 201–995 appears to be a remarkably effective agent for treatment of acromegaly secondary to ectopic GHRH secretion.