Endocrine Abstracts

Introduction: Acromegaly is a rare disease which results from a GH producing adenoma. Around 70–80% are macroadenomas. The therapeutic options currently available are surgery, radiotherapy (RT) and medical treatment (MT). According to literature microadenomas have a higher remission rate, around 80%.

Methods: A retrospective chart review of the patients with acromegaly treated in our centre from 1976 to 2011 was performed. In terms of disease control at present it was considered: Controlled with therapy when GH and IGF1 were normal but under medical therapy, persistent disease when the disease was not controlled and remission. Remission was considered when a period longer than 6 months without therapy on the last visit day, with GH <2.5 ng/ml, normal IGF1 and GH nadir with PTGO <1 ng/ml. This were the safe criteria.

Results: Among 57 patients, there were 42 (73.7%) female. Mean age of diagnosis 49.3±14.9 and a mean follow up duration of 10.8±7.9 years. The median GH values on the diagnosis were 18.35 ng/ml, and IGF1 761 ng/ml. There was 44 (77.2%) macroadenomas. Remission was observed in 5 (50%) of the microadenomas and 23 (52.3%) of the macroadenomas, 9 (39.1%) with extension out of sella turcica. Eighteen (31.6%) were controlled under therapy and 11 (19.3%) had persistence of disease. All of the cases in remission were first treated with transfenoidal surgery, 10 (35.7%) were also treated with MT (three microadenomas and seven macroadenomas), and 5 (17.8%) macroadenomas with MT plus RT.

Conclusions: The results of these study shows a similar remisson rate between micro and macroadenomas, (52.3 vs 50%) even though the macroadenomas less frequently have safe criteria just with surgery. This results also showed that the macrodenomas confined to the sella gets in remission more frequently than the invasive tumours.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.