Diagnosis and treatment of 90 patients with pituitary GH-secreting adenoma

The earliest and most common manifestations in 83 of 90 patients with pituitary GH-secreting adenoma were coarsing of facial features and enlarged extremities.Decresed visual acuity and visual fields defect occured in 28 cases(31%) and 24 cases(26.7%) respectively. In 2l patients the disease was accompanied by diabetes millitus and in 12 patients by IGT.The basal GH level in all of the 90 patients was ＞5μg/L and in 34 cases ＞80μg/L. The functional GH secretion was not decreased to ＜ 5μg/L.after oral administration of glucose in 39 patients or 0.6 mg atropine in 18 patients.The plasma PRL level was ＞25μg/L(2～126μg/L ) in 14 of 26 patients. The CT scan or MRI examination in 88 patients showed the evidence of pituitay adenoma. All of 90 patients received the treatment of operation,macroadenomas were found in 41 cases(45.6%) and microadenomas in 49 cases(54.4%) ,suprasellar extension of the adenoma revealed in 33 cases,among them,11 cases presented compression of the optic chiasm,invasion of the adenoma into cavernous sinus or sphenoidal sinus in 14 cases,and compression of the third cranial nerve and carotisinterna arteria in 3 cases.33 patients received postoperation radiotherapy.The GH level decreased in 92.3%(71/77 cases) ,and it was ＜5μg/L,after operation in 62.8%(48/77 cases) . The visual condition improved in 7 patients after operation.The total operative complications including diabetes insipitus,intracranial infection,hemorrhage and CSF rhniorrhea were 8.9%(8/90 cases) .These results indicate that most patients with GH-secreting adenoma presented typical clinical manifestations and good response to operation and radiotherapy.