Long Term Treatment With the Somatostatin Analog SMS 201–995 in a Patient With a Thyrotropin- and Growth Hormone-Secreting Pituitary Adenoma

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Abstract
A patient with a mixed pituitary tumor secreting TSH and GH was treated, starting 3 months after partial adenomectomy, with the somatostatin analog SMS 201–995 for 8 months. Somatostatin itself inhibited TSH, GH, and α-subunit release by the tumor both in vivo and in vitro. Long term treatment with twice daily sc injections of SMS 201–995 resulted in decreased TSH secretion and lower serum thyroid hormone levels. However, euthyroidism was achieved only when the patient was treated with three daily 200-μg injections of SMS 201–995. After 30 weeks of SMS 201–995 therapy, TSH secretion increased, while GH secretion remained suppressed. After withdrawal for 6 months, SMS 201–995 (100 μg, sc, twice daily) again completely inhibited TSH secretion. SMS 201–995 did not alter the volume of the residual adenomatous tissue. We conclude that SMS 201–995 may be a valuable therapeutic agent for the management of patients with a thyrotroph adenoma. However, desensitization may occur during long term treatment.

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