Acromegaly

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Diagnosing and Treating Acromegaly

Acromegaly can be difficult to diagnose, since patients may experience seemingly unrelated symptoms. (Widening feet, skin tags, vision problems, and changes in libido are just a few of the varied symptoms of acromegaly.) An individual may have sought treatment for these symptoms individually – from a primary care doctor, an eye doctor, a dermatologist, or other specialist. Since a patient may not mention the full list of symptoms to the specialists, neither the patient nor the doctors may recognize the connection immediately.

When acromegaly is suspected, the patient should be given blood tests to measure levels of growth hormone (GH) and insulin-like growth factor I (IGF-I). Based on the results, dynamic testing (GH suppression test) may be needed. If the test results indicate acromegaly, the patient will then be sent for imaging tests to look for a pituitary tumor.

Magnetic resonance imaging (MRI) and computerized tomography (CT) scans produce detailed images of the brain and allow doctors to detect the presence of a tumor. Both of these tests are noninvasive, but they do require time in a scanner to produce tiny slices of images that are then combined into three-dimensional pictures. Sometimes the patient will need a special contrast agent in advance to increase the visibility of any abnormality found.

Treatment Options
Acromegaly is most often treated surgically, by removing the pituitary tumor causing the overproduction of growth hormone. (See Surgery for a Pituitary Tumor.) In cases where surgery is not recommended, or to optimize surgery outcomes, pituitary tumors may be treated with medications to suppress GH production or block its effects at the receptor level. If the disease persists, long-term medications or radiation could be used.

Pituitary tumors are complex lesions that should be treated at major medical centers, by a team experienced in the diagnosis and treatment of tumors affecting the hormones.

Weill Cornell Brain and Spine Center is fortunate to be home to an internationally recognized surgical team with advanced skills in minimally invasive procedures to remove pituitary tumors. Neurosurgeon Theodore Schwartz, MD, and otolaryngological (ENT) surgeon Vijay Anand, MD, routinely use endonasal (through the nose) approaches to removing pituitary tumors, with no head or facial scarring. (See video of endonasal surgery technique.) The team has operated successfully on tumors that other surgeons have deemed impossible to remove. (See video of patient who had a giant tumor removed endonasally.) Dr. Dobri is well versed in all available medications for acrogmegaly, and has taken care of many patients with complex disease that requires combination medical therapy.

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Reviewed by: Georgiana Dobri, M.D.
Last reviewed/last updated: June 2018