 SOM230 will be administered to all patients at a dose of 1200 μg given subcutaneously twice daily Figure. One treatment cycle will be defined as four weeks of therapy. Complete blood counts will be obtained, and neurologic examinations and contrast-enhanced cranial MRI scans will be performed as described below see Table 7-1. Serum IGF levels will be measured at the start of treatment, and at each MRI assessment point. Plasma pharmacokinetic studies will be performed in the subset of patients who consent to this additional study procedure. Participation in the pharmacokinetic component of this study is not mandatory. 