{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T01:21:31Z","timestamp":1771464091357,"version":"3.50.1"},"reference-count":10,"publisher":"The Endocrine Society","issue":"6","license":[{"start":{"date-parts":[[2023,12,7]],"date-time":"2023-12-07T00:00:00Z","timestamp":1701907200000},"content-version":"vor","delay-in-days":36,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labor and Welfare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>A 41-year-old woman presented with a headache, diplopia, weight gain, moon face, and central obesity. Her plasma adrenocorticotropin (ACTH) level was 25.5\u2005pmol\/L (116\u00a0pg\/mL) (normal range, 1.6-13.9\u2005pmol\/L [7.2-63.3\u2005pg\/mL]), serum cortisol level was 397.3\u2005nmol\/L (14.4\u2005\u00b5g\/dL) (normal range, 195.1-540.7\u2005nmol\/L [7.1-19.6\u2005\u00b5g\/dL]), and urinary free cortisol was 413.9\u2005nmol\/day (150.3\u2005\u00b5g\/day) (normal range, &amp;lt;221.5\u00a0mmol\/day [&amp;lt;80.3\u2005\u00b5g\/day]). ACTH-dependent hypercortisolism was present, with cortisol suppression using a high-dose dexamethasone suppression test. Cushing disease was diagnosed and a contrast-enhanced magnetic resonance imaging scan demonstrated a 36-mm pituitary tumor with right cavernous sinus invasion. Before surgery, 20\u2005mg pasireotide long-acting-release was initiated, and her symptoms rapidly improved. After 1 month, obvious tumor shrinkage was observed, ACTH and cortisol levels decreased, and diplopia resolved; therefore, we continued medical therapy. After 11 months, her ACTH and cortisol levels normalized, and most of the tumor had disappeared. The clinical course in this case suggests that pasireotide may be useful for preoperative treatment and primary medical therapy, at least in some patients with Cushing disease caused by a large tumor predicted to have difficulty achieving remission by surgery.<\/jats:p>","DOI":"10.1210\/jcemcr\/luad141","type":"journal-article","created":{"date-parts":[[2023,12,7]],"date-time":"2023-12-07T22:48:28Z","timestamp":1701989308000},"source":"Crossref","is-referenced-by-count":1,"title":["Efficacious Primary Pasireotide Therapy in a Case of a Large Invasive Adrenocorticotropin-secreting Pituitary Tumor"],"prefix":"10.1210","volume":"1","author":[{"given":"Yuko","family":"Tamaki","sequence":"first","affiliation":[{"name":"Department of Diabetes and Endocrinology, Nara Medical University, Kashihara , Nara 634-8522 , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junko","family":"Nakaue","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, Nara Medical University, Kashihara , Nara 634-8522 , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumihiko","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nara Medical University , Kashihara, Nara 634-8522 , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1337-9246","authenticated-orcid":false,"given":"Yutaka","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, Nara Medical University, Kashihara , Nara 634-8522 , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2023,12,7]]},"reference":[{"issue":"5","key":"2023120722444353800_luad141-B1","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1111\/joim.12975","article-title":"Current management of Cushing's 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meta-analysis","volume":"23","author":"Stroud","year":"2020","journal-title":"Pituitary"},{"issue":"1","key":"2023120722444353800_luad141-B5","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/S2213-8587(17)30326-1","article-title":"Efficacy and safety of once-monthly pasireotide in Cushing's disease: a 12 month clinical trial","volume":"6","author":"Lacroix","year":"2018","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"12","key":"2023120722444353800_luad141-B6","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1507\/endocrj.15-0463","article-title":"Therapeutic outcomes in patients undergoing surgery after diagnosis of Cushing's disease: A single-center study","volume":"62","author":"Yamada","year":"2015","journal-title":"Endocr J"},{"issue":"6","key":"2023120722444353800_luad141-B7","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1111\/cen.14081","article-title":"Long-term efficacy and safety of once-monthly pasireotide in Cushing's disease: A phase III extension study","volume":"91","author":"Fleseriu","year":"2019","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"10","key":"2023120722444353800_luad141-B8","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1507\/endocrj.EJ17-0487","article-title":"Impact of preoperative pasireotide therapy on invasive octreotide-resistant acromegaly","volume":"65","author":"Yamamoto","year":"2018","journal-title":"Endocr J"},{"issue":"6","key":"2023120722444353800_luad141-B9","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/S2213-8587(19)30113-5","article-title":"Potential antitumour activity of pasireotide on pituitary tumours in acromegaly","volume":"7","author":"Coopmans","year":"2019","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"5","key":"2023120722444353800_luad141-B10","doi-asserted-by":"crossref","first-page":"1803","DOI":"10.1210\/jc.2013-1497","article-title":"Sustained improvements in plasma ACTH and clinical status in a patient with Nelson's syndrome treated with pasireotide LAR, a multireceptor somatostatin analog","volume":"98","author":"Katznelson","year":"2013","journal-title":"J Clin Endocrinol Metab"}],"container-title":["JCEM Case 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