Successful debulking of plurihormonal pituitary macroadenoma with long-acting pasireotide and dopamine agonist combination therapy

Terri W Jerkins, Randy K Jerkins, Robbi Franklin, Terri W Jerkins, Randy K Jerkins, Robbi Franklin

Abstract

Long-acting pasireotide and bromocriptine provided biochemical control of growth hormone and prolactin in a patient with plurihormonal pituitary macroadenoma, allowing near-complete tumor excision while restoring pituitary function and avoiding adjunctive radiotherapy. Pasireotide initiation resulted in hyperglycemia, which stabilized after a few months and resolved upon pasireotide discontinuation (ACCESS; NCT01995734).

Keywords: endocrinology; metabolic disorders; pasireotide and bromocriptine.

Conflict of interest statement

TJ is on the Speakers Bureau for Novo Nordisk, AstraZeneca, Jansen and AbbVie. RJ is on the Speakers Bureau for Novo Nordisk. RF has no conflict of interest to declare.

Figures

Figure 1
Figure 1
Levels of (A) prolactin, (B) GH, and (C) IGF‐1. Broken blue lines indicate the reference range for prolactin (2.1‐17.1 μg/L), the diagnostic threshold level for acromegaly for GH (>1.0 μg/L),6 and the age‐normalized reference range for IGF‐1 (35‐196 μg/L), respectively. GH, growth hormone; IGF‐1, insulin‐like growth factor 1
Figure 2
Figure 2
Magnetic resonance imaging of pituitary adenoma relative to the time of diagnosis and treatment of acromegaly: (A) 1st MRI, (B) 3rd MRI, (C) before surgery, and (D) after surgery. MRI, magnetic resonance imaging

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