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Acromegaly

Acromegaly is an enlargement of the bones of the hands, feet, and face that occurs when the body overproduces hormones that control growth.

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What is acromegaly?
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by Dr. William D. Knopf
Acromegaly is a condition in which the pituitary gland makes too much growth hormone after normal growth of the skeleton is finished. This causes the bones of the hands, feet, head, and face to grow larger than normal. Acromegaly can be caused by a pituitary gland tumor.
What are the symptoms of acromegaly?
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by Dr. William D. Knopf
The name acromegaly comes from the Greek words for the terms "extremities" and "enlargement," reflecting one of its most common symptoms-the abnormal growth of hands and feet. Swelling of hands and feet is often an early feature, with patients noticing a change in their ring or shoe size, particularly shoe width. Gradually, bone changes alter the patient's facial features-the brow and lower jaw p...
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What causes acromegaly?
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by Dr. William D. Knopf
Acromegaly is caused by the prolonged overproduction of growth hormone (GH) by the pituitary gland. The pituitary produces several important hormones that control body functions such as growth and development, reproduction, and metabolism. But hormones never seem to act simply and directly. They usually cascade or flow in a series, affecting each other's production or release into the bloodstream...
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How acromegaly is caused by pituitary tumors?
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by Dr. William D. Knopf
In more than 95 percent of people with acromegaly, a benign tumor of the pituitary gland, called an adenoma, produces excess growth hormone (GH). Pituitary tumors are labeled either microadenomas or macroadenomas, depending on their size. Most GH-secreting tumors are macroadenomas, meaning they are larger than 1 cm. Depending on their location, these larger tumors may compress surrounding brain s...
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How common is acromegaly?
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by Dr. William D. Knopf
Small pituitary adenomas are common affecting about 17 percent of the population. However, research suggests that most of these tumors do not cause symptoms and rarely produce excess growth hormone (GH). Scientists estimate that three to four out of every million people develop acromegaly each year and about 60 out of every million people suffer from the disease at any time. Because the clinical ...
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How is acromegaly treated?
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by Dr. William D. Knopf
Currently, treatment options include surgical removal of the tumor, medical therapy, and radiation therapy of the pituitary. The goals of treatment are to: Reduce excess hormone production to normal levels. Relieve the pressure that the growing pituitary tumor may be exerting on the surrounding brain areas. Preserve normal pituitary function or treat hormone deficiencies. Improve the sympto...
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How is acromegaly treated through surgery?
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by Dr. William D. Knopf
Surgery is the first option recommended for most people with acromegaly because it is often a rapid and effective treatment. A surgeon reaches the pituitary via an incision through the nose or inside the upper lip and, with special tools, removes the tumor tissue in a procedure called transsphenoidal surgery. This procedure promptly relieves the pressure on the surrounding brain regions and leads...
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How medical therapy is used in treating acromegaly?
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by Dr. William D. Knopf
Medical therapy is most often used if surgery does not result in a cure, and sometimes, it is used to shrink large tumors before surgery. Three medication groups are used to treat acromegaly. Somatostatin analogs (ssas) are the first medication group used to treat acromegaly. They shut off growth hormone (GH) production and are effective in lowering GH and insulin-like growth factor 1 (IGF-I) le...
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How radiation therapy is used in treating acromegaly?
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by Dr. William D. Knopf
Radiation therapy is usually reserved for people who have some tumor remaining after surgery and who do not respond to medications. Because radiation leads to a slow lowering of growth hormone (GH) and insulin-like growth factor 1 (IGF-I) levels, these patients often also receive medication to lower hormone levels. The full effect of this therapy may not occur for many years. The two types of ra...
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What treatment for acromegaly is most effective?
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by Dr. William D. Knopf
No single treatment is effective for all patients. Treatment should be individualized, and often combined, depending on a patient's characteristics such as age and tumor size. If the tumor has not yet invaded surrounding nonpituitary tissues, removal of the pituitary adenoma by an experienced neurosurgeon is usually the first choice. Even if a cure is not possible, surgery may be performed if th...
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