Outcomes of Management of Pituitary Adenoma by Use of Octreotide Injections Preoperatively
DOI:
https://doi.org/10.36552/pjns.v26i4.832Keywords:
Serum IGF, OctreotideAbstract
Objective: This study explored the effects of octreotide injections in patients with pituitary adenoma pre-operatively.
Material and Methods: A quasi-observational study was conducted on 12 patients in the Neurosurgery department of the Punjab Institute of Neurosciences (PINS) with a diagnosis of pituitary adenoma. To determine the size of the tumor, we did an MRI brain with pituitary protocol and after octreotide medication. The mode of diagnosis was clinical status, MRI brain, and biopsy of the tumor. We gave 14 short-acting octreotide injections to all patients before surgery and monitored their clinical and serum IGF levels. After the completion of 14 injections of octreotide, we planned surgery for the complete excision of the tumor. We performed IGF level 2 weeks after surgery. Then, we gave long-acting octreotide injections to all patients after every 28 days.
Results: The mean age was 43 years. 67% of patients were male and 33% of patients were female. 92% of patients presented with decreased vision. 17% of patients presented to us with complete loss of vision. In 17% of patients, the vision of the patients improved. Serum IGF levels significantly decreased after short-acting octreotide, surgical excision, and long-acting octreotide therapy.
Conclusion: With the use of octreotide therapy clinical status and outcomes of management of pituitary adenoma improve.
References
Daly AF, Beckers A. The epidemiology of pituitary adenomas. Endocrinology and Metabolism Clinics, 2020; 49 (3): 347-55.
Daniel PM. Anatomy of the hypothalamus and pituitary gland. Journal of Clinical Pathology. Supplement (Ass. Clin. Path.), 1976; 7: 1.
Dasgupta A, Kalra S. Thymic endocrinology Part-1. J Pak Med Assoc. 2021; 71 (9): 2278-2280.
Solari D, Pivonello R, Caggiano C, Guadagno E, Chiaramonte C, Miccoli G, Cavallo LM, De Caro MD, Colao A, Cappabianca P. Pituitary adenomas: what are the key features? What are the current treatments? Where is the future taking us? World Neurosurgery, 2019; 127: 695-709.
Vilar L, Vilar CF, Lyra R, Lyra R, Naves LA. Acromegaly: clinical features at diagnosis. Pituitary,
; 20 (1): 22-32.
Ershadinia N, Tritos NA. Diagnosis and treatment of acromegaly: an update. In Mayo Clinic Proceedings, 2022 Feb. 1; (Vol. 97, No. 2: pp. 333-346). Elsevier.
Buchfelder M, Feulner J. Neurosurgical treatment of acromegaly. Progress in Molecular Biology and Translational Science, 2016; 138: 115-39.
Mehta GU, Lonser RR. Management of hormone-secreting pituitary adenomas. Neuro-oncology, 2017; 19 (6): 762-73.
Samson SL, Nachtigall LB, Fleseriu M, Gordon MB, Bolanowski M, Labadzhyan A, Ur E, Molitch M, Ludlam WH, Patou G, Haviv A. Maintenance of acromegaly control in patients switching from injectable somatostatin receptor ligands to oral octreotide. The Journal of Clinical Endocrinology & Metabolism, 2020; 105 (10): e3785-97.
Thorner MO, Besser GM, Wass JA, Liuzzi A, Hall R, Muller EE, Chiodini PG. Bromocriptine in acromegaly. The New England Journal of Medicine, 1981; 305 (18): 1092.
Giustina A, Arnaldi G, Bogazzi F, Cannavò S, Colao A, De Marinis L, De Menis E, Degli Uberti E, Giorgino F, Grottoli S, Lania AG. Pegvisomant in acromegaly: an update. Journal of
endocrinological investigation, 2017; 40 (6): 577-89.
Gheorghiu ML. Updates in outcomes of stereotactic radiation therapy in acromegaly. Pituitary, 2017; 20 (1): 154-68.
Lundin P, Engström BE, Karlsson FA, Burman P. Long-term octreotide therapy in growth hormone-secreting pituitary adenomas: evaluation with serial MR. American Journal of Neuroradiology, 1997; 18 (4): 765-72.
Fukuhara N, Horiguchi K, Nishioka H, Suzuki H, Takeshita A, Takeuchi Y, Inoshita N, Yamada S. Short-term preoperative octreotide treatment for TSH-secreting pituitary adenoma. Endocrine Journal, 2015; 62 (1): 21-7.
Solari D, Cavallo LM, Cappabianca P. Surgical approach to pituitary tumors. Handbook of Clinical Neurology, 2014; 124: 291-301.
Ferolla P, Faggiano A, Grimaldi F, Ferone D, Scarpelli G, Ramundo V, Severino R, Bellucci MC, Camera LM, Lombardi G, Angeletti G. Shortened interval of long-acting octreotide administration is effective in patients with well-differentiated neuroendocrine carcinomas in progression on standard doses. Journal of Endocrinological Investigation, 2012; 35 (3): 326-31.
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Pakistan Journal Of Neurological Surgery
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The work published by PJNS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Copyrights on any open access article published by Pakistan Journal of Neurological Surgery are retained by the author(s).
