J Korean Endocr Soc.  2007 Apr;22(2):135-141. 10.3803/jkes.2007.22.2.135.

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

• Kim DJ
• Seo YJ
• Kim NH
• Chung HS
• Eun CR
• Choi HJ
• Kim HS
• Yang SJ
• Park J
• Yoo HJ
• Park SY
• Lee YJ
• Ryu OH
• Lee KW
• Kim HY
• Seo JA
• Kim SG
• Kim NH
• Choi KM
• Baik SH
• Choi DS

• KMID: 1523095
• DOI: http://doi.org/10.3803/jkes.2007.22.2.135

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.

Keyword

Acromegaly; Empty sella syndrome; Octreotide

MeSH Terms

Acromegaly*
Empty Sella Syndrome*
Growth Hormone
Hemorrhage
Humans
Infarction
Insulin-Like Growth Factor I
Jugular Veins
Necrosis
Octreotide*
Pituitary Gland
Pituitary Neoplasms
Somatostatin
Growth Hormone
Insulin-Like Growth Factor I
Octreotide
Somatostatin

Figure

• 

  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.

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