Endocrine Abstracts

Introduction: Acromegaly is a rare, chronic disease characterized by increased secretion of growth hormone, most commonly by autonomous adenoma of the anterior pituitary. Mortality is 2–3 times higher than in general population. So that, it is vital to achieve biochemical cure. We present a case in which patient was successfully treated with stereotactic radiotherapy (SRT)- CyberKnife and preserved pituitary function.

Case report: A 39-years old men was admitted to endocrinological outpatient department due to signs and symptoms suggestive for acromegaly. He noticed changes in his face shape, enlargement of hands and feet. He complained about excessive sweating and headache. Laboratory results confirmed diagnosis and excluded hypopituitarism. MRI of pituitary gland revealed microadenoma (8×6 mm), which did not compress optic chiasm. Before transphenoidal resection of the lesion patient received three octreotide injections. After surgery due to persistent disease, octreotide was re-introduced (dose: 30 mg/monthly). Then, because of drug intolerance, it was replaced with lanreotide (120 mg/monthly). Still, we did not achieve treatment goals. Patient refused to be re-operated. Finally, he underwent stereotactic radiotherapy (CyberKnife). Lanreotide was withdrawn twelve months after SRT. On regular check-up, 18 months after radiotherapy, patient met the criteria of cured acromegaly. Function of other pituitary axes was preserved.

Conclusions: Radiotherapy in acromegalic patients might be useful in case of uncontrolled disease and drug intolerance after surgery. Radiotherapy may lead to biochemical control, thereby limiting the necessity of lifelong medical therapy. SRT is recommended over conventional radiotherapy due to lesser side effects, shorter time to achieving remission and shorter treatment duration.