A young women with secondary amenorrhea and galactorrhea. MRI shows a tumour of < 10mm diameter in the pituitary fossa. Treatment is: (PGI May 2010)
|A||Hormonal therapy for withdrawal bleeding|
1). Trans-sphenoidal surgery: Usually the treatment of choice.
Somatostatin analogues eg octreotide & Lanreotide. (Ref. Hari - 18th, ed., Pg 2896).
Dopamine agonist – Bromocriptine & cabergoline are also use.
3). Radiotherapy: If surgery inappropriate or as adjuvant; may take years to work,
a. GH Receptor Antagonist, Pegvisomant, antagonizes endogenous GH action by blocking peripheral GH binding to its receptor.
b. Consequently, serum IGF-I levels are suppressed, reducing the deleterious effects of excess endogenous GH. (PNQ) (Ref. Hari 18thed., Pg 2896)
Extra Edge: (Ref. Hari 18th ed., Pg 2882)
1). Carney syndrome is characterized by spotty skin pigmentation, myxomas, and endocrine tumors, including testicular, adrenal, and pituitary adenomas. Acromegaly occurs in about 20% of these patients.
2). McCune-Albright syndrome consists of polyostotic fibrous dysplasia, pigmented skin patches, and a variety of endocrine disorders, including acromegaly, adrenal adenomas, and autonomous ovarian function.