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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

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Published on: January 17, 2018

Acromegaly pathogenesis and treatment.

Shlomo Melmed¹

¹Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA. Melmed@csmc.edu

The Journal of Clinical Investigation

|November 4, 2009

Summary

Acromegaly, caused by excess growth hormone (GH), leads to serious health issues. Effective management of GH and IGF1 levels through surgery, radiation, or novel medications improves patient outcomes and reduces mortality.

Area of Science:

Endocrinology
Oncology

Background:

Acromegaly results from excess growth hormone (GH) hypersecretion, typically due to pituitary adenomas.
Elevated GH and IGF1 levels cause disproportionate growth and comorbidities like arthritis and glucose intolerance.
Untreated acromegaly significantly increases mortality risk due to cardiovascular, cerebrovascular, and pulmonary dysfunction.

Purpose of the Study:

To review the pathogenesis of acromegaly.
To discuss current and emerging management strategies for acromegaly.

Main Methods:

Review of existing literature on acromegaly.
Discussion of surgical, radiological, and pharmacological treatment options.
Highlighting novel therapeutic agents in clinical trials.

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Main Results:

Somatostatin receptor (SSTR) ligands inhibit GH release and tumor growth.
GH receptor antagonists effectively lower IGF1 levels.
Novel peptides with polyreceptor affinities show promise in clinical trials.

Conclusions:

Effective control of GH and IGF1 hypersecretion is crucial for managing acromegaly.
Tumor ablation or stabilization improves comorbidities and reduces mortality.
Emerging therapies offer improved treatment options for acromegaly patients.