Aggressive tumors and difficult choices in acromegaly

The Author(s) 2013. This article is published with open access at Springerlink.com Purpose The current article looks at some of the factors associated with pituitary adenomas displaying unusually aggressive biological and clinical behaviour in patients with acromegaly. Methods This was a retrospective, narrative review of previously published evidence chosen at the authors ’ dis-cretion and presented from the perspective of a Latin American case study. Findings and Conclusions Although most pituitary tumors in acromegalic patients are benign and non-aggressive many can behave more aggressively, compro-mising local surrounding structures. These lesions tend to respond poorly to somatostatin analogs, have a higher risk of recurrence after surgery and, thus, a worse prognosis. Patients with more aggressive tumors constitute a particu-lar challenge, as they often require several therapeutic approaches and may be difficult to manage, especially when options are restricted due to limited resources