# Somatotroph pituitary neuroendocrine tumour (acromegaly)

Source: https://onco.cc/cancers/somatotroph-pitnet/  
OnCo record `somatotroph-pitnet` (Cancer). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A somatotroph tumour is a pituitary tumour that makes too much growth hormone, causing acromegaly in adults (enlarging hands, feet and face, diabetes, heart and joint disease) or gigantism in children. Surgery through the nose comes first; if hormone levels stay high, somatostatin analogue injections, the blocker pegvisomant or radiotherapy bring them down, restoring a normal life expectancy.

## Summary

The 2022 WHO classification places the somatotroph tumour in the PIT1 lineage with densely and sparsely granulated subtypes (the sparsely granulated tumour being larger, more invasive and less responsive to first-generation somatostatin analogues) beside the mammosomatotroph and mixed tumours (Asa 2022). The 13th Acromegaly Consensus Conference (2019) set out multidisciplinary management at pituitary tumour centres of excellence: surgery, radiotherapy and medical therapy, their results and side effects, and how they are combined and personalised (Giustina 2020); the 2013 consensus on medical treatment defined biochemical, clinical and tumour-volume goals and the place of somatostatin receptor ligands, the growth hormone receptor antagonist and dopamine agonists (Giustina 2014).

How it differs from its parent: the harm comes from the hormone rather than the mass, so biochemical control (normal IGF-1 and growth hormone) is the treatment target and predicts survival; the granulation subtype predicts drug response; and the disease is often diagnosed a decade after onset because the changes are slow.

How common: no separate incidence figure in the sources read.

Treatment: transsphenoidal surgery first; first-generation somatostatin analogues (octreotide, lanreotide) or pasireotide, pegvisomant, or cabergoline for persistent disease, alone or combined; radiotherapy including radiosurgery for residual tumour not controlled medically, as the consensus documents describe (Giustina 2020; Giustina 2014).

## Fields

- Kind: Cancer
- Last checked: 2026-09-24
- Also known as: Somatotroph tumour; Somatotroph tumour (acromegaly); Growth hormone-secreting pituitary adenoma; GH-secreting PitNET; Somatotroph adenoma; Gigantism (in children)
- Tags: subtype-page; wave4; rare
- Group: endocrine
- Burden: The pituitary tumour behind acromegaly; the acromegaly consensus conferences give its clinical figures and the parent page the pituitary tumour figures. GLOBOCAN does not count pituitary tumours.
- Subtypes: Densely granulated somatotroph pituitary tumour (responds to first-generation somatostatin analogues); Sparsely granulated somatotroph pituitary tumour (larger, invasive, less responsive); Mammosomatotroph and mixed somatotroph-lactotroph tumours; Somatotroph tumour in gigantism (children; AIP or GPR101 germline in some)
- Biomarkers: IGF-1 and growth hormone after glucose; Granulation pattern and cytokeratin staining; PIT1 lineage; Somatostatin receptor 2 and 5 expression (drug response); AIP and GPR101 germline testing in young or familial cases

## Sections of this record

The page is a hub with ten sections in reading order; large sections have their own page. The same plan as JSON: https://onco.cc/api/v1/cancers/somatotroph-pitnet/sections.json

- Overview (on the hub): The TL;DR, the family this cancer belongs to, the organ, who gets it and what the state of the art is. https://onco.cc/cancers/somatotroph-pitnet/#overview
- What it is (on the hub): Anatomy, the subtypes and how they differ, how it is staged, and where advanced disease spreads. https://onco.cc/cancers/somatotroph-pitnet/#what-it-is [4 subtypes]
- Finding it (on the hub): How it shows itself, how it is confirmed, what screening exists, and the biomarkers clinicians test for. https://onco.cc/cancers/somatotroph-pitnet/#finding-it [4 biomarkers]
- Treating it (on the hub): The standard of care by setting, the medicines, surgery and radiotherapy named in it, and the regimens behind them. https://onco.cc/cancers/somatotroph-pitnet/#treating-it [2 settings, 1 decision with options]
- Evidence (on the hub): Trials recruiting now, the landmark trials, the key papers and what they mean, the latest literature, and the milestones year by year. https://onco.cc/cancers/somatotroph-pitnet/#evidence
- The science (on the hub): The molecular landscape: the targets and how often each appears, the pathways, the mechanics stages and the preclinical models. https://onco.cc/cancers/somatotroph-pitnet/#science [2 targets]
- Where you are (own page): Cases by country, the UK and NHS pathway and other country lenses, and the expert centres with trials on record. https://onco.cc/cancers/somatotroph-pitnet/where-you-are/
- Living with it (on the hub): The decisions you may face, the aids that walk through them, the warnings on record, the first sixty days and the questions to ask. https://onco.cc/cancers/somatotroph-pitnet/#living-with-it [9 questions]
- What is coming (own page): Everything in development, the open problems and what is being done about them, the roadmaps, and what changed on this record. https://onco.cc/cancers/somatotroph-pitnet/coming/ [3 medicines]
- Data (own page): Every connected record, the notes, the JSON, Markdown and RDF twins, and where the record came from and when it was checked. https://onco.cc/cancers/somatotroph-pitnet/data/ [8 connected records]

## Standard of care

- First line: Transsphenoidal surgery at a pituitary centre. ([Pituitary tumours (pituitary neuroendocrine tumours) and pituitary carcinoma](https://onco.cc/cancers/pituitary-tumours/))
- Persistent disease: Somatostatin analogues or pasireotide, pegvisomant, cabergoline, alone or combined; radiotherapy for residual tumour not controlled medically. ([Pasireotide](https://onco.cc/drugs/pasireotide/), [Pegvisomant](https://onco.cc/drugs/pegvisomant/), [Cabergoline](https://onco.cc/drugs/cabergoline/), [Stereotactic radiosurgery (Gamma Knife, CyberKnife, linac SRS)](https://onco.cc/technologies/radiosurgery-srs/))

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Acromegaly
- NCI PDQ: pituitary tumours treatment: https://www.cancer.gov/types/pituitary/treatment
- Asa 2022, Endocrine Pathology: overview of the 2022 WHO classification of pituitary tumours: https://doi.org/10.1007/s12022-022-09703-7
- Giustina 2020, Rev Endocr Metab Disord: multidisciplinary management of acromegaly, a consensus: https://doi.org/10.1007/s11154-020-09588-z
- Giustina 2014, Nature Reviews Endocrinology: consensus on the medical treatment of acromegaly: https://doi.org/10.1038/nrendo.2014.21

## Connected records

- cancers: [Corticotroph pituitary neuroendocrine tumour (Cushing disease and silent corticotroph tumour)](https://onco.cc/cancers/corticotroph-pitnet/), [Gonadotroph pituitary neuroendocrine tumour (non-functioning adenoma)](https://onco.cc/cancers/gonadotroph-pitnet/), [Lactotroph pituitary neuroendocrine tumour (prolactinoma)](https://onco.cc/cancers/lactotroph-pitnet/), [Pituitary tumours (pituitary neuroendocrine tumours) and pituitary carcinoma](https://onco.cc/cancers/pituitary-tumours/), [Thyrotroph pituitary neuroendocrine tumour (TSH-secreting)](https://onco.cc/cancers/thyrotroph-pitnet/)
- technologies: [Stereotactic radiosurgery (Gamma Knife, CyberKnife, linac SRS)](https://onco.cc/technologies/radiosurgery-srs/)
- drugs: [Cabergoline](https://onco.cc/drugs/cabergoline/), [Pasireotide](https://onco.cc/drugs/pasireotide/), [Pegvisomant](https://onco.cc/drugs/pegvisomant/)

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JSON: https://onco.cc/api/v1/entities/somatotroph-pitnet.json