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성장 호르몬과 갑상선 자극 호르몬을 동시에 분비하는 뇌하수체 선종에서 서방형 옥트레오타이드의 효과

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Author(s)
김남경하유진이호영김미경박근규김일만장혁원김혜순
Keimyung Author(s)
Kim, Mi KyungPark, Keun GyuKim, Hye SoonChang, Hyuk WonKim, El
Department
Dept. of Internal Medicine (내과학)
Dept. of Radiology (영상의학)
Dept. of Neurosurgery (신경외과학)
Journal Title
대한내분비학회지
Issued Date
2010
Volume
25
Issue
4
Abstract
Growth hormone (GH) and thyroid stimulating hormone (TSH)-secreting pituitary adenomas are very rare and they account for only 0.5% for all pituitary adenomas. These adenomas are usually treated with surgery, but this surgery is not easy because the tumor is usually huge and invasive. We reported here on a case of a GH-TSH-secreting adenoma in a 23-year-old male patient who was initially treated with octreotide LAR. He presented with symptoms of headache, palpitation and a visual defect that he had for the 3 months. He had hypertrophy of the frontal bone and enlargement of both the hands and feet. The visual field test showed bitemporal hemianopsia. The laboratory examinations showed high serum levels of free T4, TSH and free alpha-subunit. Additionally, the serum levels of GH and insulin-like growth factor-I (IGF-I) were increased. GH was not suppressed below 1µg/L by an oral 75g glucose loading test, and TSH was not stimulated by thyrotropin-releasing hormone (TRH). Because sellar MRI showed invasive macroadenoma encasing the vessels, we initially tried octreotide LAR for treatment. A year later, the IGF-I and thyroid function tests were normalized and the size of the tumor was reduced with cystic change. The symptoms of palpitation and headache were improved without a change of the visual field defect.






Keywords: Acromegaly; Octreotide LAR; Pituitary adenoma; TSH-secreting tumor
TSH와 GH를 함께 분비하는 뇌하수체 선종은 매우 드물며, 수술
적 제거가 가장 좋으나, 대부분 거대선종이며 주변 조직 침습이 심
한 경우 수술로 완치가 어렵다. 두통과 심계항진으로 내원한 환자에
서 TSH와 GH를 함께 분비하는 뇌하수체 거대 선종 진단 후 octreotide
LAR 치료로 호르몬의 정상화 및 종양의 크기 감소를 경험하였
기에 보고하고자 한다.
Alternative Title
The Effect of Octreotide LAR on GH and TSH Co-Secreting Pituitary Adenoma
Keimyung Author(s)(Kor)
김미경
박근규
김혜순
장혁원
김엘
Publisher
School of Medicine
Citation
김남경 et al. (2010). 성장 호르몬과 갑상선 자극 호르몬을 동시에 분비하는 뇌하수체 선종에서 서방형 옥트레오타이드의 효과. 대한내분비학회지, 25(4), 378–381. doi: 10.3803/EnM.2010.25.4.378
Type
Article
ISSN
2093-596X
DOI
10.3803/EnM.2010.25.4.378
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/38451
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
1. School of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학)
1. School of Medicine (의과대학) > Dept. of Radiology (영상의학)
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