serum growth hormone (day curve average)3.2 ?

A 64-year-old woman presented with features of acromegaly. An MR scan showed a pituitary tumour with cavernous sinus extension. She underwent trans-sphenoidal surgery and histology of the pituitary tissue showed numerous cells immunostaining for growth hormone.

Investigations (6 months postoperatively):

MR scan of pituitaryenlarged sella, residual tumour in right cavernous sinus

serum growth hormone (day curve average)3.2 ?g/L (<2)

serum insulin-like growth factor 142.0 nmol/L (3.3C23.3)

What is the most appropriate next step in management?
A . conventional external beam radiotherapy to pituitary region
B . long-acting octreotide
C . pegvisomant
D . repeat trans-sphenoidal surgery
E . watchful waiting

View Answer

Answer: B