Acromegaly and hyperprolactinemia in a patient with polyostotic fibrous dysplasia: dynamic endocrine studies and treatment with the somatostatin analogue octreotide

J Endocrinol Invest. 1994 Jan;17(1):59-65. doi: 10.1007/BF03344964.


Acromegaly and hyperprolactinemia have been described in association with polyostotic fibrous dysplasia; the pathogenetic mechanisms involved in the development of the endocrinopathies is unknown. We report a 26-year-old man with polyostotic fibrous dysplasia and hypersecretion of GH and PRL. Plasma GH, PRL, and insulin-like growth factor-I (IGF-I) were elevated. Glucose-non-suppressible plasma GH concentrations, GH responsiveness to TRH and GHRH, and GH suppression after a test-dose of somatostatin, octreotide, and bromocriptine were found. Plasma GHRH levels were within the normal range (< 25 ng/l). Computed tomography of the sella turcica and visual fields were normal. [111In-DTPA-D-Phe1]-octreotide scintigraphy were used to localize a possible tumor; no radioactivity was visualized at the site of the hypothalamus, the pituitary or elsewhere in the body but a considerable accumulation of radioactivity was found in the os frontalis. Therapy with octreotide by continuous sc infusion partially suppressed GH and IGF-I (and normalized PRL). The results suggest that hypersecretion of GH in our patient is not due to a GH-secreting pituitary tumor, eutopic or ectopic hypersecretion of GHRH or autonomous somatotroph function. The origin of the disease in this patient might be an abnormal hypothalamic regulation of somatotrophs and/or an alteration in the transmembrane signalling systems.

Publication types

  • Case Reports

MeSH terms

  • Acromegaly / blood
  • Acromegaly / complications*
  • Acromegaly / drug therapy*
  • Adult
  • Bromocriptine / therapeutic use
  • Fibrous Dysplasia, Monostotic / blood
  • Fibrous Dysplasia, Monostotic / complications*
  • Fibrous Dysplasia, Monostotic / drug therapy*
  • Growth Hormone / blood
  • Growth Hormone-Releasing Hormone / blood
  • Humans
  • Hyperprolactinemia / blood
  • Hyperprolactinemia / complications*
  • Hyperprolactinemia / drug therapy*
  • Injections, Subcutaneous
  • Insulin-Like Growth Factor I / analysis
  • Iodine Radioisotopes
  • Male
  • Octreotide / administration & dosage
  • Octreotide / therapeutic use*
  • Prolactin / blood
  • Somatostatin / therapeutic use
  • Time Factors


  • Iodine Radioisotopes
  • Bromocriptine
  • Somatostatin
  • Insulin-Like Growth Factor I
  • Prolactin
  • Growth Hormone
  • Growth Hormone-Releasing Hormone
  • Octreotide