310 QUABBE AND PLÖCKINGER109. Ladas SD, Thalassinos NC, Ioannides G, Raptis SA. Does acromegalyreally predispose to an increased prevalence <strong>of</strong> gastrointestinaltumours? Clin Endocrinol 1994;41:597–601.110. Losa M, Wolfram G, Mojto J, Schopohl J, Spiess Y, Huber R, etal. Presence <strong>of</strong> growth hormone-releasing hormone-like immunoreactivityin human tumors: characterization <strong>and</strong> immunological<strong>and</strong> biological properties. J Clin Endocrinol Metab 1990;70:62–68.111. Faglia G, Arosio M, Bazzoni N. Ectopic acromegaly. In: MelmedS, ed. Acromegaly, Endocrinology <strong>and</strong> Metabolism Clinics <strong>of</strong>North America. WB Saunders, Philadelphia, 1992, vol. 21, pp.575–595.112. Barkan A L, Shenker Y, Grekin R J, Vale W W, LLoyd R V, BealsT F. Acromegaly due to ectopic growth hormone (GH)-releasinghormone (GHRH) production: Dynamic studies <strong>of</strong> GH <strong>and</strong> ectopicGHRH secretion. J Clin Endocrinol Metab 1986;63:1057–1064.113. Melmed S, Ziel FH, Braunstein GD, Downs T, Frohman LA. Medicalmanagement <strong>of</strong> acromegaly due to ectopic production <strong>of</strong> growthhormone-releasing hormone by a carcinoid tumor. J Clin EndocrinolMetab 1988;67:395–399.114. Thorner MO, Frohman LA, Leong DA, Thominet J, Downs T,Hellmann P, et al. Extrahypothalamic growth-hormone-releasingfactor (GRF) secretion is a rare cause <strong>of</strong> acromegaly: plasma GRHlevels in 177 acromegalic patients. J Clin Endocrinol Metab1984;59:846–849.115. Asa SL, Kovacs K. <strong>Pituitary</strong> pathology in acromegaly. In: MelmedS, ed. Acromegaly. Endocrinology <strong>and</strong> Metabolism Clinics <strong>of</strong>North America. WB Saunders, Philadelphia, 1992, vol. 21, pp.553–574.116. Ezzat S, Asa SL, Stefaneanu L, Whittom R, Smyth HS, Horvath E,et al. Somatotroph hyperplasia without pituitary adenoma associatedwith a long st<strong>and</strong>ing growth hormone-releasing hormoneproducingbronchial carcinoid. J Clin Endocrinol Metab 1994;78:555–560.117. Scheithauer BW, Kovacs K, R<strong>and</strong>all RV, Horvath E, Okazaki H,Laws ER Jr. Hypothalamic neuronal hamartoma <strong>and</strong> adenohypophysealneuronal choristoma: their association with growth hormoneadenoma <strong>of</strong> the pituitary gl<strong>and</strong>. J Neuropathol Exp Neurol1983;42:648–663.118. Asa SL, Scheithauer BW, Bilbao JM, Horvath E, Ryan N, KovacsK, et al. A case for hypothalamic acromegaly: a clinicopathologicalstudy <strong>of</strong> six patients with hypothalamic gangliocytomas producinggrowth hormone-releasing factor. J Clin Endocrinol Metab1984;58:796–803.119. Saeger W, Puchner MJA, Lüdecke DK. Combined sellar gangliocytoma<strong>and</strong> pituitary adenoma in acromegaly or Cushing’s disease.A report <strong>of</strong> 3 cases. Virchows Arch Int J Pathol 1994;425:93–99.120. Puchner MJA, Lüdecke DK, Saeger W, Riedel M, Asa SL.Gangliocytomas <strong>of</strong> the sellar region—a review. Exp Clin Endocrinol1995;103:129–149.121. Horvath E, Kovacs K, Scheithauer BW, Lloyd RV, Smyth HS.<strong>Pituitary</strong> adenoma with neuronal choristoma (PANCH): compositelesion or lineage infidelity? Ultrastruct Pathol 1994;18:565–574.122. Roth KA, Wilson DM, Eberwine J, Dorin RI, Kovacs K, BenschKG, et al. Acromegaly <strong>and</strong> phaeochromocytoma: a multiple endocrinesyndrome caused by a plurihormonal adrenal medullarytumor. J Clin Endocrinol Metab 1986;63:1421–1426.123. Saito H, Sano T, Yamasaki R, Mitsuhashi S, Hosoi E, Saito S.Demonstration <strong>of</strong> biological activity <strong>of</strong> a growth hormone-releasinghormone-like substance produced by a pheochromocytoma.Acta Endocrinol (Copenh) 1993;129:246–250.124. Bevan JS, Asa SL, Rossi ML, Esiri MM, Adams CBT, Burke CW.Intrasellar gangliocytoma containing gastrin <strong>and</strong> growth hormonereleasinghormone associated with a growth hormone-secretingpituitary adenoma. Clin Endocrinol 1989;30:213–224.125. Genka S, Soeda H, Takahashi M, Katakami H, Sanno N, OsamuraY, et al. Acromegaly, diabetes insipidus, <strong>and</strong> visual loss caused bymetastatic growth hormone-releasing hormone-producing malignantpancreatic endocrine tumor in the pituitary gl<strong>and</strong>—Casereport. J Neurosurg 1995;83:719–723.126. Sano T, Asa SL, Kovacs K. Growth hormone-releasing hormoneproducingtumors: clinical, biochemical, <strong>and</strong> morphological manifestations.Endocr Rev 1988;9:357–373.127. Beck C, Burger HG. Evidence for the presence <strong>of</strong> immunoreactivegrowth hormone in cancers <strong>of</strong> the lung <strong>and</strong> stomach. Cancer1972;30:75–79.128. Melmed S, Ezrin C, Kovacs K, Goodman RS, Frohman LA.Acromegaly due to secretion <strong>of</strong> growth hormone by an ectopicpancreatic islet-cell tumor. N Engl J Med 1985;312:9–17.128a. Beuschlein F, Strasburger CJ, Siegerstetter V, Moradpour D,Lichter P, Bidlingmaier M, Blum HE, Reincke M. Acromegalycaused by secretion <strong>of</strong> growth hormone by a Non-Hodgkin’s lymphoma.New Engl J Med 2000;342:1871–1876.129. Steiner H, Dahlbäck O, Waldenström J. Ectopic growth-hormoneproduction <strong>and</strong> osteoarthropathy in carcinoma <strong>of</strong> the bronchus.Lancet i,1968;783–785.130. Greenberg PB, Martin TJ, Beck C, Burger HG. Synthesis <strong>and</strong>release <strong>of</strong> human growth hormone from lung carcinoma in cellculture. The Lancet i,1972:350–352.131. Pun KK, Chan G, Kung A, Lam K, Chan FL, Wang C. McCune-Albright syndrome with acromegaly. Horm Metab Res 1989;21:527,528.132. Chanson P, Dib A, Visot A, Derome PJ. McCune-Albright syndrome<strong>and</strong> acromegaly: clinical studies <strong>and</strong> responses to treatmentin five cases. Eur J Endocrinol (Copenh.) 1994;131:229–234.133. Weinstein LS, Shenker A, Gejman PV, Merino MJ, Friedman E,Spiegel AM. Activating mutations <strong>of</strong> the stimulatory G protein in theMcCune-Albright syndrome. N Engl J Med 1991;325:1688–1695.134. Spada A, Bassetti M, Gil-del-Alamo P, Saccomanno K, Lania A.Etiology <strong>of</strong> acromegaly: a molecular biological approach. Metabolism1995;44(Suppl 1):31–33.135. Br<strong>and</strong>i ML, Marx SJ, Aurbach GD, Fitzpatrick LA. Familial multipleendocrine neoplasia type I: a new look at pathophysiology.Endocr Rev 1987;8:391–405.136. Pestell RG, Alford FP, Best JD. Familial acromegaly. ActaEndocrinologica (Copenh) 1989;121:286–289.137. McCarthy MI, Noonan K, Wass JAH, Monson JP. Familial acromegaly:studies in three families. Clin Endocrinol 1990;32:719–728.138. Benlian P, Giraud S, Lahlou N, Roger M, Blin C, Holler C, et al.Familial acromegaly: a specific clinical entity—further evidencefrom the genetic study <strong>of</strong> a three-generation family. Eur JEndocrinol 1995;133:451–456.138a. Ackermann F, Krohn K, Windgassen M, Buchfelder M, FahlbuschR, Paschke R. Acromegaly in a family without a mutation in themenin gene. Exp Clin Endocrinol Diabetes 1999;107:93–96.139. Hartman ML, Veldhuis JD, Vance ML, Faria ACS, FurlanettoRW, Thorner MO. Somatotropin pulse frequency <strong>and</strong> basal concentrationsare increased in acromegaly <strong>and</strong> are reduced by successfultherapy. J Clin Endocrinol Metab 1990;70:1375–1384.139a. Wass JAH. Growth hormone, insulin-like growth factor-I <strong>and</strong> itsbinding proteins in the follow-up <strong>of</strong> acromegaly. J Endocrinol1997;155:517–519.139b. St<strong>of</strong>fel-Wagner B, Springer W, Bidlingmaier F, Klingmüller D. Acomparison <strong>of</strong> different methods for diagnosing acromegaly. ClinEndocrinol 1997;46:531–537.139c. Giustina A, Barkan A, Casanueva FF, Cavagnini F, Frohman L, HoK, Veldhuis J, Wass J, von Werder K, Melmed S. Criteria for cure<strong>of</strong> acromegaly: A consensus statement. J Clin Endocrinol Metab2000;85:526–529.140. Barkan AL, Beitins IZ, Kelch RP. Plasma insulin-like growth factor-I/somatomedin-Cin acromegaly: correlation with the degree<strong>of</strong> growth hormone hypersecretion. J Clin Endocrinol Metab1988;67:69–73.141. Ezzat S, Forster MJ, Berchtold P, Redelmeier DA, Boerlin V,Harris AG. Acromegaly. Clinical <strong>and</strong> biochemical features in 500patients. Medicine 1994;73:233–240.142. Fagin JA, Roberts CT Jr, Le Roith D, Brown AT. Coordinatedecreases <strong>of</strong> tissue insulinlike growth factor I posttranscriptionalalternative mRNA transcripts in diabetes mellitus. Diabetes1989;38:428–434.
CHAPTER 17 / ACROMEGALY 311143. V<strong>and</strong>eHaar MJ, Moats-Staats BM, Davenport ML,Walker JL,Ketelslegers JM, Sharma BK, et al. Reduced serum concentrations<strong>of</strong> insulin-like growth factor-I (IGF-I) in protein-restricted growingrats are accompanied by reduced IGF-I mRNA levels in liver<strong>and</strong> skeletal muscle. J Endocrinol 1991;130:305–312.144. LeRoith D, Roberts CT Jr. Insulin-like growth factors <strong>and</strong> theirreceptors in normal physiology <strong>and</strong> pathological states. J PediatEndocrinol 1993;6:251–255.145. Baxter RC, Martin JL. Radioimmunoassay <strong>of</strong> growth hormonedependentinsulinlike growth factor binding protein in humanplasma. J Clin Invest 1986;78:1504–1512.146. Blum WF, Ranke MB, Kietzmann K, Gauggel E, Zeisel HJ, BierichJR. A specific radioimmunoassay for the growth hormone (GH)-dependent somatomedin-binding protein: its use for diagnosis <strong>of</strong>GH deficiency. J Clin Endocrinol Metab 1990;70:1292–1298.147. Grinspoon S, Clemmons D, Swearingen B, Klibanski A. Seruminsulin-like growth factor-binding protein-3 levels in the diagnosis<strong>of</strong> acromegaly. J Clin Endocrinol Metab 1995;80:927–932.148. Clemmons DR, Thissen JP, Maes M, Ketelslegers JM, UnderwoodLE. Insulin-like growth factor-I (IGF-I) infusion into hypophysectomizedor protein-deprived rats induces specific IGF-binding proteinsin serum. Endocrinology 1989;125:2967–2972.149. Sklar C, Sarafoglou K, Whittam E. Efficacy <strong>of</strong> insulin-like growthfactor binding protein 3 in predicting the growth hormone responseto provocative testing in children treated with cranial irradiation.Acta Endocrinol (Copenh) 1993;129:511–515.150. Roelen CAM, Donker GH, Thijssen JHH, Koppeschaar HPF,Blankenstein MA. High affinity growth hormone binding proteinin plasma <strong>of</strong> patients with acromegaly <strong>and</strong> the effect <strong>of</strong> octreotidetreatment. Clin Endocrinol 1991;37:373–378.151. Amit T, Ish-Shalom S, Glaser B, Youdim MBH, Hochberg Z.Growth-hormone-binding protein in patients with acromegaly.Horm Res 1992;37:205–211.152. Kratzsch J, Blum WF, Ventz M, Selisko T, Birkenmeyer G, KellerE. Growth hormone-binding protein-related immunoreactivity in theserum <strong>of</strong> patients with acromegaly is regulated inversely by growthhormone concentration. Eur J Endocrinol 1995;132:306–312.153. Haffner D, Schaefer F, Girard J, Ritz E, Mehis O. Metabolic clearance<strong>of</strong> recombinant human growth hormone in health <strong>and</strong> chronicrenal failure. J Clin Invest 1994;93:1163–1171.154. Hattori N, Kato Y, Murakami Y, Hashida S, Ishikawa E, Mohri Z,et al. Urinary growth hormone levels measured by ultrasensitiveenzyme immunoassay in patients with renal insufficiency. J ClinEndocrinol Metab 1988;66:727–732.155. Sukegawa I, Hizuka N, Takano K, Asakawa K, Horikawa R,Hashida S, et al. Urinary growth hormone (GH) measurements areuseful for evaluating endogenous GH secretion. J Clin EndocrinolMetab 1988;66:1119–1123.156. Hourd P, Edwards R. Current methods for the measurement <strong>of</strong>growth hormone in urine. Clin Endocrinol 1994;40:155–170.157. Hattori N, Shimatsu A, Kato Y, Koshiyama H, Ishikawa Y, TanohT, et al. Urinary excretion <strong>of</strong> human growth hormone: daily variation<strong>and</strong> relationship with albumin <strong>and</strong> α 1 -microglobulin in urine.Acta Endocrinol (Copenh) 1989;121:533–537.158. Evans AJ, Willis DS, Wood PJ. The assay <strong>of</strong> urinary growth hormonein normal <strong>and</strong> acromegalic adults. Clin Endocrinol 1991;35:413–418.159. Sukegawa I, Hizuka N, Takano K, Asakawa K, Horikawa R,Hashida S, et al. Measurement <strong>of</strong> nocturnal urinary growth hormonevalues. Acta Endocrinol (Copenh) 1989;121:290–296.160. Winer LM, Shaw MA, Baumann G. Urinary growth hormoneexcretion rates in normal <strong>and</strong> acromegalic man: a critical appraisal<strong>of</strong> its potential clinical utility. J Endocrinol Invest 1989;12:461–467.161. Lunt H, Tucker AJ, Bullen H, Gibbs C, Wilkin TJ. Overnight urinarygrowth hormone measurement in the diagnosis <strong>of</strong> acromegaly.Clin Endocrinol 1990;33:205–212.162. Fredstorp L, Werner S. Growth hormone <strong>and</strong> insulin-like growthfactor-1 in blood <strong>and</strong> urine as response markers during treatment<strong>of</strong> acromegaly with octreotide: a double-blind placebo-controlledstudy. J Endocrinol Invest 1993;16:253–258.163. Weissberger AJ, Ho KY, Stuart MC. Quantification <strong>of</strong> urinarygrowth hormone (GH) excretion by centrifugal ultrafiltration <strong>and</strong>radioimmunoassay: appraisal <strong>of</strong> the relationship between 24 h urinaryGH <strong>and</strong> mean 24 h serum GH levels in normal <strong>and</strong> abnormalstates <strong>of</strong> GH secretion. Clin Endocrinol 1989;30:687–698.164. Main KM, Lindholm J, V<strong>and</strong>eweghe M, Skakkebaek NE. Urinarygrowth hormone excretion in acromegaly: diagnostic value in milddisease activity. Acta Endocrinol (Copenh) 1993;129:409–413.165. Thalange NKS, Gill MS, Gill L, Whatmore AJ, Addison GM, PriceDA, et al. Infradian rhythms in urinary growth hormone excretion.J Clin Endocrinol Metab 1996;81:100–106.166. Chang-DeMoranville BM, Jackson IMD. <strong>Diagnosis</strong> <strong>and</strong> endocrinetesting in acromegaly. In: Melmed S, ed. Acromegaly, Endocrinology<strong>and</strong> Metabolism Clinics <strong>of</strong> North America. WB Saunders,Philadelphia, 1992, vol. 21, pp. 649–668.167. Harvey S. Thyrotrophin-releasing hormone: a growth hormonereleasingfactor. J Endocrinol 1990;125:345–358.168. De Marinis L, Mancini A, Zuppi P, Anile C, Maira G. Paradoxicalgrowth hormone response to thyrotropin-releasing hormone inacromegaly. Clinical correlations <strong>and</strong> prognostic value. ActaEndocrinol (Copenh) 1990;122:443–449.169. Brockmeier SJ, Buchfelder M, Fahlbusch R. TRH/GnRH test inacromegaly—Long-term follow-up experience with successfullytreated patients. Horm Metab Res 1993;25:275–277.170. Quabbe H-J. Treatment <strong>of</strong> acromegaly by trans-sphenoidal operation,90-yttrium implantation <strong>and</strong> bromocriptine: results in 230patients. Clin Endocrinol 1982;16:107–119.171. Watanobe H, Tamura T. Clinical significance <strong>of</strong> the growth hormoneresponse to vasoactive intestinal peptide <strong>and</strong> gonadotropinreleasinghormone in acromegaly. Neuropeptides 1995;28:115–124.172. Watanobe H, Sasaki S, Sone K, Takebe K. Paradoxical response <strong>of</strong>growth hormone to peptide histidine methionine in acromegaly:comparison with the effects <strong>of</strong> thyrotropin-releasing hormone <strong>and</strong>vasoactive intestinal peptide. J Clin Endocrinol Metab 1991;72:982–985.173. Lawrence AM, Goldfine ID, Kirsteins L. Growth hormone dynamicsin acromegaly. J Clin Endocrinol 1970;31:239–247.174. Popovic V, Damjanovic S, Micic D, Manojlovic D, Micic J,Casanueva FF. Modulation by glucocorticoids <strong>of</strong> growth hormonesecretion in patients with different pituitary tumors. Neuroendocrinology1993;58:465–472.175. Giustina A, Bresciani E, Bussi AR, Bollati A, Bonfanti C, BugariG, et al. Characterization <strong>of</strong> the paradoxical growth hormoneinhibitory effect <strong>of</strong> galanin in acromegaly. J Clin Endocrinol Metab1995;80:1333–1340.176. Sirota P, Gil-Ad I, Hermesh H, Munitz H, Laron Z, Weizman R.Growth hormone response to TRH in families multiply affectedwith schizophrenia. Biol Psychiatry 1992;31:1241–1244.177. Faglia G, Paracchi A, Ferrari C, Beck-Peccoz P. Evaluation <strong>of</strong> theresults <strong>of</strong> trans-sphenoidal surgery in acromegaly by assessment<strong>of</strong> the growth hormone response to thyrotrophin-releasing hormone.Clin Endocrinol 1978;8:373–380.178. Osman IA, James RA, Chatterjee S, Mathias D, Kendall-Taylor P.Factors determining the long-term outcome <strong>of</strong> surgery for acromegaly.Q J Med 1994;87:617–623.179. Smals AEM, Pieters GFFM, Smals AGH, Hermus ARMM,Benraad TJ, Kloppenborg PWC. Growth hormone responses to thereleasing hormones GHRH <strong>and</strong> GnRH <strong>and</strong> the inhibitors somatostatin<strong>and</strong> bromocriptine in TRH-responsive <strong>and</strong> non-responsiveacromegalics. Acta Endocrinol (Copenh) 1987;116:53–58.180. Smals AEM, Pieters GFFM, Smals AGH, Hermus ARMM,Benraad TJ, Kloppenborg PWC. The higher the growth hormoneresponse to growth hormone releasing hormone the lower theresponse to bromocriptine <strong>and</strong> thyrotrophin releasing hormone inacromegaly. Clin Endocrinol 1987;27:43–47.181. Villabona CM, Soler J, Virgili N, Gómez JM, Montaña E, NavarroMA. Growth hormone response to thyrotropin-releasing hormonein acromegalic patients: reproducibility <strong>and</strong> dose-response study.Horm Res 1992;37:14–17.
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DIAGNOSIS AND MANAGEMENT OFPITUITAR
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To my beloved Hazel, whose love and
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PrefacePituitary tumors represent a
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CHAPTER 13 / PITUITARY SURGERY 2251
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CHAPTER 13 / PITUITARY SURGERY 227F
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CHAPTER 13 / PITUITARY SURGERY 229F
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CHAPTER 14 / MEDICAL THERAPY 24714M
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CHAPTER 14 / MEDICAL THERAPY 249Tab
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CHAPTER 14 / MEDICAL THERAPY 251One
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CHAPTER 14 / MEDICAL THERAPY 253Fig
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CHAPTER 14 / MEDICAL THERAPY 255and
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CHAPTER 14 / MEDICAL THERAPY 257abs
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- Page 360 and 361: 344 YOUNGFigure 20-1 Serum prolacti
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370 PERNICONE AND SCHEITHAUERFigure
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372 PERNICONE AND SCHEITHAUERFigure
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384 PERNICONE AND SCHEITHAUER32. Th
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CHAPTER 23 / SELLAR TUMORS 38723Sel
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CHAPTER 23 / SELLAR TUMORS 389mode
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CHAPTER 23 / SELLAR TUMORS 4297.2.2
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450 SAEGERTermDiffuse hyperplasiaNo
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452 SAEGERFigure 24-3 ACTH cell hyp
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454 SAEGERFigure 24-9 Septic absces
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456 SAEGERabnormality of the arachn
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458 SAEGERFigure 24-15 Densely gran
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460 SAEGER76. Asa SL. Tumors of the
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462 MILLER, ZHANG, AND KLIBANSKItio
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464 MILLER, ZHANG, AND KLIBANSKItum
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INDEXABC peroxidase method, 94Acrom
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INDEX 469Chordomas (cont.) Cranioph
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INDEX 471Glycoprotein hormones/SV4O
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INDEX 473Invasion (cont.)Lymphomas
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INDEX 475Osteogenic sarcomas, 416-4
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INDEX 477Pro-opiomelanocortin (POMC
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INDEX 479Visual outcomes (cont.) Vi
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