Acromegaly: Medical and Surgical Considerations

Otolaryngol Clin North Am. 2022 Apr;55(2):331-341. doi: 10.1016/j.otc.2021.12.007. Epub 2022 Mar 4.

Abstract

Acromegaly results from excessive secretion of insulinlike growth factor-1 and growth hormone, which most commonly occurs because of pituitary somatotrophinoma. Diagnostic features of acromegaly include elevated insulinlike growth factor-1 and growth hormone; lesion on brain MRI; and clinically dysmorphic features, such as soft tissue swelling, jaw prognathism, and acral overgrowth. Transsphenoidal resection is the primary therapy for individuals with acromegaly, even in the cases where gross total resection is not possible because of parasellar extension and cavernous sinus involvement. For recurrent or persistent disease after resection, systemic medications and stereotactic radiosurgery are used.

Keywords: Acromegaly; Growth hormone; Insulinlike growth factor-1; Remission rates; Somatotrophinoma; Stereotactic radiosurgery; Transsphenoidal resection.

Publication types

  • Review

MeSH terms

  • Acromegaly* / diagnosis
  • Acromegaly* / etiology
  • Acromegaly* / surgery
  • Adenoma* / surgery
  • Growth Hormone-Secreting Pituitary Adenoma* / complications
  • Growth Hormone-Secreting Pituitary Adenoma* / pathology
  • Growth Hormone-Secreting Pituitary Adenoma* / surgery
  • Human Growth Hormone*
  • Humans
  • Pituitary Neoplasms* / complications
  • Pituitary Neoplasms* / surgery
  • Radiosurgery* / adverse effects
  • Radiosurgery* / methods
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Human Growth Hormone