Journal List > J Korean Endocr Soc > v.22(2) > 1003354

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Kim, Seo, Kim, Chung, Eun, Choi, Kim, Yang, Park, Yoo, Park, Lee, Ryu, Lee, Kim, Seo, Kim, Kim, Choi, Baik, and Choi: Two Cases of Acromegaly with Empty Sella Syndrome Treated by Long-Acting Release Octreotide
Case Report
Journal of Korean Endocrine Society

Journal of Korean Endocrine Society 2007; 22(2): 135-141.

Published online: 20 April 2007

DOI: https://doi.org/10.3803/jkes.2007.22.2.135

Two Cases of Acromegaly with Empty Sella Syndrome Treated by Long-Acting Release Octreotide

Dong Jin Kim, Young Jin Seo, Nam Hoon Kim, Hye Soo Chung, Chai Ryoung Eun, Hye Jung Choi, Hye Sook Kim, Sae Jeong Yang, Juri Park, Hye Jin Yoo, Soo Yeon Park, Yun Jeong Lee, Ohk Hyun Ryu, Kye Won Lee, Hee Young Kim, JiA Seo, Sin Gon Kim, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi

Department of Internal Medicine, Korea University College of Medicine, Korea.

Received 6 September 2006       Accepted 3 November 2006

Copyright © 2007 Korean Endocrine Society

Abstract

Two cases of typical acromegaly with empty sella syndrome presented to our institution. In the natural course of untreated pituitary adenoma, empty sella syndrome may result from necrosis by infarction or from hemorrhage of the pituitary gland. In our patients, the secretion of growth hormone continued in spite of the existence of empty sella syndrome. In one case, we confirmed the hypersecretion of growth hormone from sella by jugular vein sampling. Medical therapy with somatostatin analogue was attempted because there was no obvious mass in the sella. After 6~12 months of treatment with long-acting release octreotide, clinical features in our patients were improved, and the level of growth hormone and IGF-1 were also normalized.

Keywords: Acromegaly, Empty sella syndrome, Octreotide

Figures and Tables

Fig. 1
The sella cone-down view showed deepening of pituitary fossa and enlargement of bony sella.
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Fig. 2
Brain MRI shows enlarged bony sella and remnant pituitary mass at right side. Sella is occupied with cerebrospinal fluid.
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Fig. 3
Chest X-ray shows patchy infiltration on right lower lung and mild cardiomegaly (CT ratio = 0.53).
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Fig. 4
Skull x-ray shows deepening of bony sella.
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Fig. 5
Sella MRI shows small pituitary gland and pituitary fossa is replaced by cerebrospinal fluid.
jkes-22-135-g005

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