Abstract
Acromegaly results from sustained oversecretion of growth hormone (GH) by a pituitary tumor, or rarely by hyperplastic somatotrophs stimulated through ectopic GH-releasing hormone. Manifestations include systemic effects of GH (acral enlargement, disfigurement, soft tissue swelling, visceromegaly, nerve entrapment, arthropathy, hypertension, diabetes) and local tumor effects (visual field impairment, oculomotor paralysis, hypopituitarism, increased intracranial pressure). Diagnosis is secured by demonstration of high and nonsuppressible plasma GH levels, of elevated somatomedin C levels, and of pituitary adenoma by computed tomographic scanning. Treatment consists of removal of the pituitary tumor by the transsphenoidal route, followed, if necessary, by radiotherapy to the pituitary fossa and/or medical therapy with bromocriptine or somatostatin analogues.
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