Treatment Of Acromegaly

After the biochemical diagnosis is determined, the patient should have magnetic resonance imaging (MRI) of the pituitary gland. The majority of patients with acromegaly have a pituitary macroadenoma (>10 mm), and some patients have a smaller tumor which is more amenable to complete surgical resection. First-line treatment is surgical removal of the adenoma by an experienced pituitary neurosurgeon; results of pituitary surgery are dependent on the experience and expertise of the neurosurgeon (9). A pituitary macroadenoma, particularly with invasion into the cavernous sinus or bone, is less likely to be cured surgically but does require removal to alleviate or prevent visual loss and to allow for optimal additional treatment with focused radiation (stereotactic radiation) or conventional fractionated radiation to treat the residual tumor. Surgical treatment of acromegaly results in remission or cure in approx 66% of patients, thus a substantial number of patients require additional treatment, including medical therapy and pituitary radiation.

RESULTS OF TREATMENT OF ACROMEGALY Surgery

The results of transsphenoidal removal of a GH adenoma vary according to the experience and expertise of the neurosurgeon. Results from medical centers in

Table 1

Results of Transsphenoidal Removal of GH Adenoma from Medical Centers Performing a Large Number of Pituitary Surgeries

Table 1

Results of Transsphenoidal Removal of GH Adenoma from Medical Centers Performing a Large Number of Pituitary Surgeries

Location

No. of patients

Nl. IGF-1

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