ArticleJCEM case reports2026
Beyond biochemical control: headache resolution with pasireotide in a patient with acromegaly and residual tumor.
Article in JCEM case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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3 authors.
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Abstract
Acromegaly management is particularly challenging when pituitary adenomas invade the cavernous sinus, limiting the likelihood of complete surgical resection. We describe a case of a 40-year-old woman with acromegaly caused by a growth hormone and prolactin co-secreting pituitary macroadenoma with bilateral cavernous sinus invasion and severe, frequent headache. Despite transsphenoidal surgery, radiotherapy, and sequential medical therapy with octreotide, cabergoline, and pegvisomant over 3 years, insulin-like growth factor 1 (IGF-1) levels remained elevated and headache burden persisted. Initiation of pasireotide long-acting release was followed by rapid normalization of IGF-1 levels and complete resolution of headache, with improvement in other acromegaly related symptoms. This case supports the potential role of pasireotide in selected patients with biochemically and clinically treatment-resistant acromegaly and contributes to the growing real-world evidence regarding its use in patients with residual disease in surgically challenging locations.
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