GH Adenoma (Acromegaly)

Progressive enlargement of the hands, feet, and facial features resulting from excess growth hormone secretion by the pituitary gland.

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Skull Base and Pituitary Surgery

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1Overview

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What is this Condition?

Acromegaly results from a benign tumor of the pituitary gland at the base of the brain that secretes excessive growth hormone. In adults, since bone length no longer increases, this hormone excess causes enlargement of the hands and feet and coarsening of facial features. In children, it may cause excessive height growth (gigantism). Because changes develop very slowly, they may go unnoticed for years; most people realize later that their ring or shoe size has increased. Its importance extends beyond appearance: if untreated, it can have serious effects on the heart, blood pressure, blood sugar, and sleep. Therefore, early diagnosis and treatment are vital.

Symptoms

Enlargement of hands and feet; ring becomes tight, shoe size increases

Coarsening of facial features: prominence of the lower jaw, enlargement of nose and lips

Excessive sweating and oily skin

Joint pain, numbness in the wrist (carpal tunnel)

Snoring and sleep apnea, excessive daytime sleepiness

Persistent headache; if the tumor grows, visual disturbances or narrowing of peripheral vision

Diagnosis Methods

Blood tests are essential for diagnosis: elevated IGF-1 (a substance stimulated by growth hormone in the liver) in blood is the initial indicator. To confirm the diagnosis, glucose tolerance is performed to assess whether growth hormone is suppressed. Subsequently, MRI of the pituitary gland is performed to visualize the tumor's location and size. Additionally, potentially affected organs such as the heart, sleep patterns, and bowel are evaluated.

Treatment Methods

The first-line treatment in acromegaly is typically surgery; the tumor is removed via endoscopic transsphenoidal approach, and hormone levels normalize in many patients. When surgery alone is insufficient or inappropriate, hormone-suppressing injection or oral medications are initiated; sometimes medication and surgery are combined. When these options are inadequate, radiation therapy may be considered. The goal is to normalize hormone levels and prevent organ damage.

Tumor removal via endoscopic transsphenoidal surgery (first-line treatment)

Injection therapies that suppress growth hormone (somatostatin analogues)

Pharmacological therapy that blocks hormone effects (pegvisomant), combined with injection therapy if necessary

Radiation therapy (radiotherapy) when other options are insufficient

Treatment Path

Related Treatments

The procedures and interventions most commonly explored with this condition.

4 links

Transsfenoidal hipofizektomi, endoskopik

Transsfenoidal hipofizektomi, endoskopik procedure

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Transsfenoidal hipofizektomi (adenomektomi)

Transsfenoidal hipofizektomi (adenomektomi) procedure

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CSF Fistula Surgery (Transsphenoidal Route)

CSF Fistula Surgery (Transsphenoidal Route) procedure

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Skull Base Dural Repair

Skull Base Dural Repair procedure

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References

Greenberg MS. Handbook of Neurosurgery. 10th ed. Thieme; 2023.
Melmed S, ed. The Pituitary. 4th ed. London: Academic Press/Elsevier; 2017.
Honegger J, Reincke M, Petersenn S, eds. Pituitary Tumors: A Comprehensive and Interdisciplinary Approach. London: Academic Press/Elsevier; 2021.
Katznelson L, Laws ER Jr, Melmed S, et al. Acromegaly: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2014:3933-3951.

This content is for informational purposes and based on academic sources; consult your physician for diagnosis and treatment.

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GH Adenoma (Acromegaly)

Skull Base and Pituitary Surgery

1Overview

What is this Condition?

Symptoms

Diagnosis Methods

Treatment Methods

Related Treatments

Transsfenoidal hipofizektomi, endoskopik

Transsfenoidal hipofizektomi (adenomektomi)

CSF Fistula Surgery (Transsphenoidal Route)

Skull Base Dural Repair

References

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Transsfenoidal hipofizektomi, endoskopik

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CSF Fistula Surgery (Transsphenoidal Route)

Skull Base Dural Repair

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