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News from Sierra Nevada Memorial Hospital and Hospital Foundation

 

Sometimes I hear unusual medical terms and have to look them up as my curiosity gets the best of me. One such term is “acromegaly.“ Acromegaly is a rare condition in which the body produces too much growth from hormones, causing body tissues and bones to grow more quickly. Acromegaly affects about six people per 100,000 individuals.

A disorder of the endocrine glands, acromegaly is often caused by a benign tumor on the pituitary gland (a pea-sized gland below the brain). These individuals experience a gradual enlargement of hands and feet which is usually caused by the pituitary gland producing excess growth hormone. In over 95% of cases, it is because of a benign tumor called pituitary adenoma. Acromegaly is rarely inherited from a family member.

While it is unusual, many celebrities with this condition may sound familiar. The list includes actor and wrestler Andre the Giant, actor and wrestler Big Show, Ted Cassidy who played Lurch on The Addams Family, and motivational speaker Tony Robbins.



The tallest man in the world on record was Robert Wadlow, who measured 8′ and 11.1“ on June 27, 1940. His great size and continued growth were due to hypertrophy of his pituitary gland. In childhood this is known as gigantism, but in adulthood the increase in bone size is limited to those in the hands, feet, and face and is known as acromegaly.

It is hard to believe that such a tiny gland can have such large consequences. Diagnosed in adulthood, in addition to the symptoms of enlarged hands, feet and facial features, people will notice coarse and oily thickened skin, excessive sweating and body odor, pain, joint and muscle weakness, a deepened husky voice due to enlarged vocal cords and sinuses, and more.




Acromegaly develops slowly. Diagnosis occurs by measuring growth hormones after a patient drinks a glucose solution. Sometimes an insulin-like growth factor is measured in the blood. Once there is a diagnosis, medical imaging of the pituitary gland can help determine if an adenoma is present. The goal in treatment is to reduce growth hormone production to normal levels. Focus is given to relieving the tumor’s pressure on surrounding tissue and treating hormone deficiencies.

Surgery is usually an effective treatment and can completely cure acromegaly unless the tumor is too large to be removed. A small cut is made inside the nose or behind the upper lip to access the pituitary gland. Accessing the tumor should instantly lower the levels of growth hormones and relieve pressure on the surrounding tissues. Facial features often return to normal. Medication may be an option if growth hormone levels are higher than normal after surgery or surgery is not possible. If neither options work or are available, radiation therapy may be considered.

Follow-up appointments should be continued for life. A physician or specialist will monitor how well the pituitary gland is working, will check if the hormone replacement treatment is correct, and will gauge progress so the condition does not return.

 


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