To cure acromegalic patients, transsphenoidal surgery is considered first, especially for microadenoma. However, less than 50% of patients with macroadenoma achieve satisfactory biochemical control. Moreover, surgery may cause
hypopituitarism. Medical
therapy may offer the prospect of near normalization of
growth hormone (GH)/
insulin-like growth factor-1 levels with substantial
tumor shrinkage in a significant number of patients. Here, we report two cases of
acromegaly under treatment with
somatostatin analogs alone for more than 10 years. Case 1 was a 54-year-old man with a pituitary macroadenoma. He received 4 years of
octreotide treatment followed by 6 years of prolonged-release (PR)
lanreotide resulting in normal GH level. Case 2 was a 60-year-old woman with a 1.3 cm
pituitary tumor. She received 8 years of
octreotide treatment followed by 6 years of PR
lanreotide resulting in subnormal GH level and gallbladder sludge. She had received bilateral
total hip replacement for
hip osteoarthritis at the age of 59 years. These cases illustrate that long-term treatment with
somatostatin analogs offers an alternative choice in selected acromegalic patients, such as those with
pituitary tumor who cannot be cured by surgery, those who have unacceptable
anesthetic risk and those who refuse surgery.