Acromegaly

It is a rare disease caused by a benign tumor (pituitary adenoma) of the pituitary gland that secretes growth hormone. There may be a familial transmission. It occurs equally in men and women. It occurs in childhood and if left untreated, gigantism may occur.

What are the symptoms?

Before puberty:

• Giant

After puberty:

• Coarse facial features,
• Forward growth / elongation of the nose and chin,
• spacing of teeth,
• Inability of the jaw to close normally,
• language growth,
• snoring, sleep apnea,
• Enlargement of hands and feet (small rings, enlarged shoe size),
• Sweating,
• Trap neuropathies (nerve compression),
• Calcifications in the spine,
• Hypertension,
• diabetes,
• Heart disease.

How is the diagnosis made?

If there are signs of acromegaly, an endocrinologist should be consulted. During the blood growth hormone and IGF-1 glucose load test, growth hormone levels are diagnostic. When the diagnosis of acromegaly is made with blood tests, the tumor is visualized by performing an MRI examination of the pituitary.

How is the treatment done?

It is the removal of a pituitary tumor by a neurosurgeon. Except for very large tumors, most tumors can be treated with transsphenoidal surgery. The first step of treatment is surgery. Somatostatin analogues can be started before surgery if the patient's surgery is too high-risk or if preparation for surgery will take time.

How to follow up after surgery?

In the 3rd month, the diagnostic tests are repeated and the patient is re-evaluated. If the tumor is not completely removed, drug treatment is started. Drug therapy is carried out in the form of monthly injections. If necessary, the dose can be increased or other drugs can be added to the treatment. During the drug treatment, the patients are followed up at intervals of 3 or 6 months. If necessary, radiotherapy can be added to stop tumor growth.

What happens if it is not treated?

Acromegaly disease causes complications due to excess growth hormone. Physical and skeletal changes of acromegaly impair patients' quality of life. The most important complications are hypertension, diabetes, heart diseases and the development of secondary cancers such as colon, thyroid and breast cancer. Secondary cancers are 3 times more common in patients with acromegaly than in healthy people. These complications can be prevented in patients who are well treated and followed up regularly.