Acromegaly

Acromegaly is a chronic disease caused by excessive secretion of growth hormone. This condition is characterized by enlargement of many parts of the skeleton, especially in face, hands and feet.

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Symptoms

Acromegaly occurs only in adults, usually of middle age. 

Symptoms of Acromegaly include:

  • Abnormal growth of the bones of the face
  • Enlarged hands and feet
  • Excessive sweating
  • Headaches
  • Heart disease
  • Joint pain
  • Vision disturbances


Causes and Risk Factors

The pituitary gland controls critical body functions, including growth and body metabolism, thyroid function, the body's response to stress and reproduction. In over 90 percent of cases, acromegaly can be traced to a benign tumor of the pituitary gland, called an adenoma. Acromegaly can also be caused by tumors of the adrenal glands, lungs or pancreas. These tumors can lead to an excess of growth hormone, either because they produce it or they produce the hormone that stimulates the pituitary gland into making it.

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Diagnosis

A magnetic resonance imaging (MRI) scan is the most sensitive test for acromegaly and can quickly diagnose even small tumors (microadenomas). Sometimes computed tomography (CT) scans are used, but this test may not detect tumors that are one-centimeter in size or smaller.

Complete hormone testing is also important, and an endocrinologist may need to be consulted. A complete neuro-ophthalmologic evaluation, including a visual field exam, is also needed. Pituitary tumors, because of their location, may affect the optic nerves and cause vision disturbance or even loss of sight.

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Treatments

For a patient with a pituitary adenoma, it is important to reduce the pressure being placed on nearby structures (generally the optic nerves and chiasm) and to restore normal hormone production.

The treatment will depend on the size of the tumor, the patient's symptoms and the patient's hormone status.

Treatment may include:

  • Observation and monitoring with MRI scans and visual field studies, if the tumor is small and the patient's vision and hormone production is not threatened.
  • Surgery
  • Radiation therapy is used when parts of the tumor are left behind after surgery or where the tumors come back after surgery.
  • Stereotactic radiosurgery
  • Drugs
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