Early surgical intervention for patients with possible clinically silent somatotroph adenoma: a case series
Abstract Introduction Clinically silent somatotroph adenoma is characterized by elevated serum growth hormone but without the clinical symptoms of acromegaly, and it is considered rare. The natural history is not well understood, progress to symptomatic is uncertain, and treatment strategy has not b...
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doaj-6a07392aa25a4dfca2dc8285132ff7232020-11-25T03:19:31ZengBMCJournal of Medical Case Reports1752-19472019-03-011311610.1186/s13256-019-1981-3Early surgical intervention for patients with possible clinically silent somatotroph adenoma: a case seriesTomohiro Kawaguchi0Yoshikazu Ogawa1Teiji Tominaga2Department of Neurosurgery, Tohoku University Graduate School of MedicineDepartment of Neurosurgery, Kohnan HospitalDepartment of Neurosurgery, Tohoku University Graduate School of MedicineAbstract Introduction Clinically silent somatotroph adenoma is characterized by elevated serum growth hormone but without the clinical symptoms of acromegaly, and it is considered rare. The natural history is not well understood, progress to symptomatic is uncertain, and treatment strategy has not been established. Case presentation The first patient was a 48-year-old-Asian woman who presented with serum growth hormone 6.99 ng/ml and insulin-like growth factor 1 of 476 ng/ml, but no characteristic features of acromegaly. Five years after initial diagnosis, she presented with acromegalic facial appearance. Transsphenoidal surgery achieved gross total removal and endocrinological remission. The second patient was a 40-year-old-Asian woman who presented with serum growth hormone 31.14 ng/ml and insulin-like growth factor 1 of 709.6 ng/ml, but no characteristic features of acromegaly. Three years after initial diagnosis, she presented with acromegalic facial appearance. Transsphenoidal surgery achieved gross total removal and endocrinological remission. The third patient was a 64-year-old-Asian woman who presented with serum growth hormone 6.0 ng/ml and insulin-like growth factor 1 of 341 ng/ml, but no characteristic features of acromegaly. Eight months after initial diagnosis, hand enlargement was detected. Transsphenoidal surgery achieved gross total removal and endocrinological remission. Conclusion Due to its potential for evolving to symptomatic disease, the risks of surgery and observation for patients with somatotroph adenoma should be carefully compared from the viewpoint of better health outcome.http://link.springer.com/article/10.1186/s13256-019-1981-3AcromegalyClinically silentGrowth hormoneSomatotroph adenomaTranssphenoidal surgery |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Tomohiro Kawaguchi Yoshikazu Ogawa Teiji Tominaga |
spellingShingle |
Tomohiro Kawaguchi Yoshikazu Ogawa Teiji Tominaga Early surgical intervention for patients with possible clinically silent somatotroph adenoma: a case series Journal of Medical Case Reports Acromegaly Clinically silent Growth hormone Somatotroph adenoma Transsphenoidal surgery |
author_facet |
Tomohiro Kawaguchi Yoshikazu Ogawa Teiji Tominaga |
author_sort |
Tomohiro Kawaguchi |
title |
Early surgical intervention for patients with possible clinically silent somatotroph adenoma: a case series |
title_short |
Early surgical intervention for patients with possible clinically silent somatotroph adenoma: a case series |
title_full |
Early surgical intervention for patients with possible clinically silent somatotroph adenoma: a case series |
title_fullStr |
Early surgical intervention for patients with possible clinically silent somatotroph adenoma: a case series |
title_full_unstemmed |
Early surgical intervention for patients with possible clinically silent somatotroph adenoma: a case series |
title_sort |
early surgical intervention for patients with possible clinically silent somatotroph adenoma: a case series |
publisher |
BMC |
series |
Journal of Medical Case Reports |
issn |
1752-1947 |
publishDate |
2019-03-01 |
description |
Abstract Introduction Clinically silent somatotroph adenoma is characterized by elevated serum growth hormone but without the clinical symptoms of acromegaly, and it is considered rare. The natural history is not well understood, progress to symptomatic is uncertain, and treatment strategy has not been established. Case presentation The first patient was a 48-year-old-Asian woman who presented with serum growth hormone 6.99 ng/ml and insulin-like growth factor 1 of 476 ng/ml, but no characteristic features of acromegaly. Five years after initial diagnosis, she presented with acromegalic facial appearance. Transsphenoidal surgery achieved gross total removal and endocrinological remission. The second patient was a 40-year-old-Asian woman who presented with serum growth hormone 31.14 ng/ml and insulin-like growth factor 1 of 709.6 ng/ml, but no characteristic features of acromegaly. Three years after initial diagnosis, she presented with acromegalic facial appearance. Transsphenoidal surgery achieved gross total removal and endocrinological remission. The third patient was a 64-year-old-Asian woman who presented with serum growth hormone 6.0 ng/ml and insulin-like growth factor 1 of 341 ng/ml, but no characteristic features of acromegaly. Eight months after initial diagnosis, hand enlargement was detected. Transsphenoidal surgery achieved gross total removal and endocrinological remission. Conclusion Due to its potential for evolving to symptomatic disease, the risks of surgery and observation for patients with somatotroph adenoma should be carefully compared from the viewpoint of better health outcome. |
topic |
Acromegaly Clinically silent Growth hormone Somatotroph adenoma Transsphenoidal surgery |
url |
http://link.springer.com/article/10.1186/s13256-019-1981-3 |
work_keys_str_mv |
AT tomohirokawaguchi earlysurgicalinterventionforpatientswithpossibleclinicallysilentsomatotrophadenomaacaseseries AT yoshikazuogawa earlysurgicalinterventionforpatientswithpossibleclinicallysilentsomatotrophadenomaacaseseries AT teijitominaga earlysurgicalinterventionforpatientswithpossibleclinicallysilentsomatotrophadenomaacaseseries |
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