scholarly journals Bilateral Choroidal Metastases from Endobronchial Carcinoid Treated with Somatostatin Analogues

2016 ◽  
Vol 10 (1) ◽  
pp. 160-165
Author(s):  
Deborah De Bruyn ◽  
Jan Lamont ◽  
Erik Vanderstraeten ◽  
Simon Van Belle ◽  
Elise Platteau ◽  
...  
Keyword(s):  
Systemic Treatment ◽  
Tumor Regression ◽  
Hormone Secretion ◽  
Somatostatin Analogues ◽  
Blood Levels ◽  
Somatostatin Analogue ◽  
Computer Tomography Scan ◽  
Long Term Follow Up ◽  
Gallium 68 ◽  
Mesenterial Lymph Node

Objective: To describe a patient with bilateral multifocal choroidal metastases from an endobronchial carcinoid treated with a somatostatin analogue. Method: A 60-year-old woman presenting with photopsia in the left eye underwent an extensive ophthalmic examination, including fluorescein angiography, OCT and ultrasound. Results: Fundoscopy revealed a small retinal tear in the left eye, for which she received laser treatment. In addition, choroidal masses were detected in both eyes. Her medical history of a pneumectomy for a bronchial carcinoid six years earlier together with recent elevated chromogranin A blood levels prompted a diagnosis of choroidal metastases. Subsequently, a Gallium-68 DOTANOC positron emitting tomography/computer tomography scan revealed a spinal cord metastasis and mediastinal as well as mesenterial lymph node invasion. Systemic treatment with Sandostatin®, a somatostatin analogue was started. Up until two years after the initial presentation and treatment, these choroidal lesions remained stable without any signs of growth. Conclusion: Endobronchial carcinoid tumors have an indolent nature and long-term follow-up is recommended for early detection of metastases. Although treatment with somatostatin analogues rarely induces complete tumor regression, tumor stabilization and prevention of symptoms related to hormone secretion is achieved. This well-tolerated systemic treatment provides a worthy alternative treatment for choroidal metastasis compared to classic radiotherapy without any risk of radiation or laser-related visual loss.

scholarly journals Complete and sustained remission of neuroendocrine tumor-associated liver metastases during somatostatin analogue treatment

2011 ◽  
Vol 152 (10) ◽  
pp. 407-410
Author(s):  
György Raizer ◽  
Péter Igaz ◽  
István Pregun ◽  
Gabriella Dabasi ◽  
Károly Rácz
Keyword(s):  
Liver Metastases ◽  
Neuroendocrine Tumors ◽  
Tumor Regression ◽  
Hormone Secretion ◽  
Somatostatin Analogues ◽  
Somatostatin Analogue ◽  
Complete Regression ◽  
Sustained Remission ◽  
Inhibition Of Tumor Growth ◽  
Major Treatment

Somatostatin analogues represent a major treatment modality in the therapy of neuroendocrine tumors. Their efficacy is well documented in the inhibition of hormone secretion; however, novel data seem to underline their effectiveness in tumor regression, as well. In this report authors present a case of type 1 neuroendocrine tumors of the stomach associated with liver metastases. Somatostatin analogue treatment resulted in a complete regression of the primary tumor and the metastases within two years. This case draws attention on the importance of somatostatin analogue treatment not only in the control of hormonal symptoms but also in the inhibition of tumor growth. Orv. Hetil., 2011, 152, 407–410.

Aggravation of hypoglycemia in insulinoma patients by the long-acting somatostatin analogue octreotide (Sandostatin®)

1989 ◽  
Vol 121 (1) ◽  
pp. 34-40 ◽  
Author(s):  
C. D. A. Stehouwer ◽  
W. F. Lems ◽  
H. R. A. Fischer ◽  
W. H. L. Hackeng ◽  
M. A. B. Naafs
Keyword(s):  
Blood Glucose ◽  
Hormone Secretion ◽  
Somatostatin Analogues ◽  
Serum Glucose ◽  
Somatostatin Analogue ◽  
Transient Decrease ◽  
Glucoregulatory Hormones ◽  
Octreotide Therapy ◽  
Long Acting ◽  
Analogue Octreotide

Abstract. Recently somatostatin analogues were successfully used to control insulin-induced hypoglycemia in patients with insulinoma. We observed a transient decrease in glucose levels and symptomatic hypoglycemia after administration of the long-acting somatostatin analogue octreotide (Sandostatin®) in two insulinoma patients. We studied the acute effects of octreotide (administered before breakfast) on blood glucose and glucoregulatory hormones in these patients. In one patient, we studied the effects of glucagon replacement and changing the time of breakfast (relative to octreotide administration) on octreotide-associated changes in blood glucose and glucoregulatory hormones. Compared with control levels, octreotide therapy reduced insulin levels. During hypoglycemia glucagon and growth hormone levels were suppressed, but cortisol levels appropriately increased. The increase in catecholamine levels was normal in one patient, but markedly attenuated in the other. A transient decrease in serum glucose after octreotide was absent after glucagon replacement, but present when breakfast was taken before administration of octreotide. We conclude that in patients with insulinoma, octreotide therapy may be associated with clinically important hypoglycemia, during which counterregulatory hormone secretion may be attenuated.

scholarly journals Somatostatin analogues in acromegaly and gastroenteropancreatic neuroendocrine tumours: past, present and future

2016 ◽  
Vol 23 (12) ◽  
pp. R551-R566 ◽  
Author(s):  
Kjell Öberg ◽  
Steven W J Lamberts
Keyword(s):  
Medical Therapy ◽  
Neuroendocrine Tumours ◽  
Clinical Success ◽  
Serum Insulin ◽  
Therapeutic Option ◽  
Hormone Secretion ◽  
Somatostatin Analogues ◽  
Somatostatin Analogue ◽  
Prolonged Release ◽  
Gastroenteropancreatic Neuroendocrine Tumours

Acromegaly is a hormonal disorder that arises when the pituitary gland secretes excess growth hormone (GH), which in turn stimulates a concomitant increase in serum insulin-like growth factor 1 (IGF-1) levels. Gastroenteropancreatic neuroendocrine tumours (GEP-NET) constitute a heterogeneous group of tumours that can secrete serotonin and a variety of peptide hormones that may cause characteristic symptoms known as carcinoid syndrome or other symptoms and hormonal hypersecretion syndromes depending on the tumour’s site of origin. Current medical therapy for the treatment of acromegaly and GEP-NET involves the administration of somatostatin analogues that effectively suppress excess hormone secretion. After its discovery in 1979, octreotide became the first synthetic biologically stable somatostatin analogue with a short-acting formulation of octreotide introduced into clinical practice in the late 1980s. Lanreotide, another somatostatin analogue, became available in the mid-1990s initially as a prolonged-release formulation administered every 10 or 14 days. Long-acting release formulations of both octreotide (Sandostatin LAR and Novartis) and lanreotide (Somatuline Autogel, Ipsen), based on microparticle and nanoparticle drug-delivery technologies, respectively, were later developed, which allowed for once-monthly administration and improved convenience. First-generation somatostatin analogues remain one of the cornerstones of medical therapy in the management of pituitary and GEP-NET hormone hypersecretion, with octreotide having the longest established efficacy and safety profile of the somatostatin analogue class. More recently, pasireotide (Signifor), a next-generation multireceptor-targeted somatostatin analogue, has emerged as an alternative therapeutic option for the treatment of acromegaly. This review summarizes the development and clinical success of somatostatin analogues.

Sleep deprivation reduces LH secretion in men independently of melatonin

1991 ◽  
Vol 124 (6) ◽  
pp. 646-651 ◽  
Author(s):  
RickJ. Strassman ◽  
Clifford R. Qualls ◽  
E.Jonathan Lisansky ◽  
Glenn T. Peake
Keyword(s):  
Sleep Deprivation ◽  
Hormone Secretion ◽  
Area Under The Curve ◽  
Bright Light ◽  
Pulse Frequency ◽  
Blood Levels ◽  
Luteinizing Hormone Secretion ◽  
Normal Man ◽  
Normal Men ◽  
Lh Secretion

Abstract. Melatonin affects gonadal function in nonprimate mammals. Confirmatory data in man are not available. We assessed melatonin's acute effects on luteinizing hormone secretion in 17 normal men. We studied these men in conditions of sleep in the dark, and sleep deprivation in bright light, dim light, and bright light combined with a physiologically relevant infusion of melatonin, while measuring blood levels of immunoreactive LH every 20 min for 7 h. We compared overnight LH secretion, and LH pulse frequency, amplitude, length, interval and area under the curve using a modification of the PULSAR peak identification program, among the four treatments. Areas under the curve for peaks in all three conditions of sleep deprivation were lower than in normal sleep. The presence or absence of melatonin had no additional effect. We conclude that acute suppression of melatonin does not affect LH pulse parameters in normal man, but that sleep deprivation may reduce the amount of LH secreted per pulse.

scholarly journals Effects of combination therapy: somatostatin analogues and dopamine agonists on GH and IGF1 levels in acromegaly

2015 ◽  
Vol 88 (3) ◽  
pp. 310-313 ◽  
Author(s):  
Ana Valea ◽  
Cristina Ghervan ◽  
Mara Carsote ◽  
Andra Morar ◽  
Iulia Iacob ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Combination Therapy ◽  
Dopamine Agonist ◽  
Normal Level ◽  
Dopamine Agonists ◽  
Somatostatin Analogues ◽  
Somatostatin Analogue ◽  
Endocrine Disorder ◽  
Excessive Secretion

 Background and aims. Acromegaly is a complex endocrine disorder caused by excessive secretion of GH, secondary to a GH secreting pituitary adenoma or a mixed pituitary adenoma secreting GH and PRL.Methods. The aim of this study was to evaluate the effects of combination therapy: dopamine agonist and somatostatin analogue on GH and IGF1 levels in a group of 30 patients with acromegaly. Cabergoline in a dose of 2 mg/week and 4 mg/week respectively was associated with Sandostatin LAR in a dose of 20 mg/month and 30 mg/months respectively. Eight patients were treated with Lanreotide 30 mg/week and Cabergoline 2 mg/week and 3 patients were treated with Bromocriptine 10 mg/day and Sandostatin LAR 30 mg/month.Results. Combination therapy: Cabergoline and Sandostatin achieved normal levels of IGF1  in 32% of the patients, better results being obtained after 12 months of treatment in the group treated with 4 mg Cabergoline/week. In 37% of cases the levels of IGF1 decreased by 50% after 12 months of treatment. In the group treated with Cabergoline and Somatuline a normal level of IGF1 was achieved in 25% of patients after 12 months of treatment. The outcome for the group treated with Sandostatin and Bromocriptine was similar to that obtained under Cabergoline 2 mg/week. There was no significant correlation between the level of GH and the type or dose of dopamine agonist used.Conclusions. In conclusion, combination therapy consisting of dopamine agonist and somatostatin analogue achieves a significant reduction of IGF1 levels in patients with mixed adenomas secreting GH and PRL. A decrease in IGF1 levels is directly correlated with the dose of Cabergoline used. 

scholarly journals Somatostatin and gastrointestinal tract. Clinical experiences

2013 ◽  
Vol 154 (39) ◽  
pp. 1535-1540 ◽  
Author(s):  
László Herszényi ◽  
Emese Mihály ◽  
Zsolt Tulassay
Keyword(s):  
Gastrointestinal Tract ◽  
Gastrointestinal Hormones ◽  
Gastrointestinal Diseases ◽  
Somatostatin Analogues ◽  
Therapeutic Modality ◽  
Exocrine Function ◽  
Somatostatin Analogue ◽  
Clinical Experiences ◽  
Pancreatic Fistulas ◽  
Long Acting

The effect of somatostatin on the gastrointestinal tract is complex; it inhibits the release of gastrointestinal hormones, the exocrine function of the stomach, pancreas and bile, decreases motility and influences absorption as well. Based on these diverse effects there was an increased expectation towards the success of somatostatin therapy in various gastrointestinal disorders. The preconditions for somatostatin treatment was created by the development of long acting somatostatin analogues (octreotide, lanreotide). During the last twenty-five years large trials clarified the role of somatostatin analogues in the treatment of various gastrointestinal diseases. This study summarizes shortly these results. Somatostatin analogue treatment could be effective in various pathological conditions of the gastrointestinal tract, however, this therapeutic modality became a part of the clinical routine only in neuroendocrine tumours and adjuvant treatment of oesophageal variceal bleeding and pancreatic fistulas. Orv. Hetil., 2013, 154, 1535–1540.

scholarly journals Unresectable Recurrent Multiple Meningioma: A Case Report with Radiological Response to Somatostatin Analogues

2016 ◽  
Vol 9 (2) ◽  
pp. 520-525 ◽  
Author(s):  
Ana Ortolá Buigues ◽  
Irene Crespo Hernández ◽  
Manuela Jorquera Moya ◽  
Jose Ángel Díaz Pérez
Keyword(s):  
Somatostatin Receptors ◽  
Somatostatin Analogues ◽  
Somatostatin Analogue ◽  
Continuous Administration ◽  
Antiangiogenic Effect ◽  
Neurological Improvement ◽  
Radiological Response ◽  
Multiple Meningioma ◽  
Multiple Recurrences

Medical treatment of meningiomas is reserved for cases in which surgery and radiotherapy have failed. Given that a high percentage of meningiomas express somatostatin receptors, treatment with somatostatin analogues has been proposed. In addition, these medications have been shown to have an antiproliferative and antiangiogenic effect in vitro. To date, very few cases with clinical response and none with radiological response have been described. The case described here is the first to report a radiological response. A 76-year-old Caucasian male was first diagnosed with unresectable meningioma at age 47. The patient experienced multiple recurrences and underwent three surgeries and radiotherapy over the years from the initial diagnosis. Despite treatment, the disease continued its progression. Based on an Octreoscan positive for tumour uptake, therapy with extended-release somatostatin analogues was started. Although no clinical neurological improvement was observed, magnetic resonance imaging scans revealed a discreet but continuous radiological response over time. After >2 years of continuous administration of lanreotide, the patient remains progression free. In highly selected cases, somatostatin analogue treatment for meningioma may be beneficial. Based on our findings, treatment with somatostatin analogues should be maintained longer than previously described before evaluating treatment response.

Increase of ovarian progesterone secretion by β2-adrenergic stimulation in oestrous rats

1982 ◽  
Vol 101 (2) ◽  
pp. 268-272 ◽  
Author(s):  
Béla Zsolnai ◽  
Bertalan Varga ◽  
Edit Horváth
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Adrenergic Receptors ◽  
Hormone Secretion ◽  
Regulatory Role ◽  
Blood Levels ◽  
Ovarian Hormone ◽  
Adrenergic Stimulation ◽  
Venous Outflow ◽  
Progesterone Secretion

Abstract. Oestrous rats were anaesthetized with pentobarbital and one of the femoral arteries, femoral veins and utero-ovarian veins were cannulated. Five min blood fractions were collected from the ovary for 50 min. Following two control fractions fenoterol, noradrenaline, isoproterenol (0.5 μg/min) or 0.9% NaCl (0.02 ml/min) were infused iv for 40 min. In a group of oestrous animals fenoterol was given locally to the ovarian bursa. Blood pressure and the ovarian venous outflow were continuously recorded and blood levels of progesterone (P) and oestradiol-17β (E2) were determined by RIA. Fenoterol administered iv increased P secretion without altering ovarian blood flow, whereas noradrenaline and isoproterenol had no effect on P secretion. Fenoterol administered locally stimulated both P and E2 secretion, and this was prevented by iv infusion of propranolol. It is suggested that ovarian β2-adrenergic receptors have a regulatory role in ovarian hormone secretion.

[111In-DTPA-D-Phe1]Octreotide scintigraphy in patients with carcinoid tumours: the predictive value for somatostatin analogue treatment

1994 ◽  
Vol 131 (6) ◽  
pp. 577-581 ◽  
Author(s):  
Eva Tiensuu Janson ◽  
Jan-Erik Westlin ◽  
Barbro Eriksson ◽  
Håkan Ahlström ◽  
Sten Nilsson ◽  
...  
Keyword(s):  
Predictive Value ◽  
Somatostatin Receptor ◽  
Somatostatin Receptors ◽  
Somatostatin Analogues ◽  
University Hospital ◽  
Somatostatin Analogue ◽  
Carcinoid Tumours ◽  
Malignant Carcinoid ◽  
Receptor Scintigraphy ◽  
Octreotide Scintigraphy

Tiensuu Janson E, Westlin J-E, Eriksson B, Ahlström H, Nilsson S, Öberg K. [111In-DTPA-D-Phe1]Octrotide scintigraphy in patients with carcinoid tumours: the predictive value for somatostatin analogue treatment. Eur J Endocrinol 1994:131:577–81. ISSN 0804–4643 This study was performed to evaluate whether the presence or absence of somatostatin receptors in malignant carcinoid tumours detected by [111In-DTPA-D-Phe1]octreotide scintigraphy can be used to predict response to somatostatin analogue treatment. Thirty patients were investigated, 28 with midgut carcinoid tumours and two with foregut carcinoid tumours. Twenty-seven patients showed pathological uptake in tumour lesions at scintigraphy: of these, 22 responded to somatostatin analogue treatment using octreotide, somatuline or octastatin, while five patients failed to respond. None of the three patients displaying negative scintigraphic investigations responded to treatment with somatostatin analogues. These results show a good correlation between the somatostatin receptor status and the patients' ability to respond to somatostatin analogue treatment (p = 0.014). We conclude that somatostatin receptor scintigraphy using [111In-DTPA-D-Phe1]octreotide can be used to select patients with malignant carcinoid tumours suitable for somatostatin analogue treatment and exclude those that will not benefit from such medication. Eva Tiensuu Janson, Dept of Internal Medicine, University Hospital, S-751 85 Uppsala, Sweden

scholarly journals Germline mutations of AIP gene in somatotropinomas resistant to somatostatin analogues

2013 ◽  
Vol 168 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Josep Oriola ◽  
Tomás Lucas ◽  
Irene Halperin ◽  
Mireia Mora ◽  
Ma José Perales ◽  
...  
Keyword(s):  
Pituitary Adenomas ◽  
Conventional Treatment ◽  
Poor Response ◽  
Germline Mutations ◽  
Somatostatin Analogues ◽  
Age At Diagnosis ◽  
Somatostatin Analogue ◽  
Endocrine Tumors ◽  
Peg Treatment ◽  
Aip Gene

ObjectiveMost cases of familial isolated pituitary adenomas with mutated aryl hydrocarbon receptor-interacting protein (AIP:HGNC:358) gene develop somatotropinomas. They are characterised by an aggressive clinical phenotype including early age at diagnosis, large tumours and frequent invasiveness. There is little information on AIP gene mutations' prevalence in isolated somatotropinomas characterised by poor response to somatostatin analogue treatment. The aim of this study was to investigate the prevalence of AIP mutations in non-familial cases of somatotropinomas with poor response to conventional treatment.Design and methodsFifty patients with acromegaly (22 males/28 females, age 51±18 years) and 60 controls were included in this study performed at eight University Hospitals in Spain. None had family history of pituitary adenomas or other endocrine tumors. All patients failed to respond to conventional treatment including surgery and somatostatin analogues. Some patients received adjuvant radiotherapy and most cases required pegvisomant (PEG) treatment for normalisation of IGF1. AIP analysis was performed in DNA extracted from peripheral leucocytes, using standardised PCR protocol in which the coding regions of exons 1, 2, 3, 4, 5 and 6 were amplified. Possible deletions/duplications were studied using multiplex ligation-dependent probe amplification.ResultsSequence changes of potential different significance that could be considered as mutations or variations of unknown significance (VUS) of the AIP gene were found in four patients (8%). In two cases, two different mutations previously described were found: p.Arg9Gln and p.Phe269Phe. Two other VUS were also found: c.787+24C>T in intron 5 and c.100-18C>T in intron 1. Age at diagnosis ranged from 21 to 50 years old, and in all patients, the tumor was a macroadenoma depicting IGF1 normalisation under PEG treatment.ConclusionsAIP germline mutations show a low, but non-negligible, prevalence in non-familial acromegaly patients with tumors resistant to treatment with somatostatin analogues.

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