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Acromegaly

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    Definition and clinical picture

    Endocrinopathy due to an overactivity of eosinophilic cells of the anterior hypophyseal lobe (adenoma/hyperplasia) with an increased growth-hormone (somatotropin) production. After the epiphyseal plates are closed, this results in enlargement of acral parts (hands, feet, chin, and nose).

    Clinical symptoms
    • Joint pain
    • Enlarged nose and lips
    • Enlarged tongue and ears
    • Excessive mandibular growth causing prognathism
    • Prominence of zygomatic bones and maxillary sinus enlargement
    • Disturbed vision due pressure from the hypophysis on the optic chiasm
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    Proof

    Visual diagnosis

    Laboratory: Assay of somatotropin (STH) and insulin-like growth factor (IGF-I, somatomedin)

    X-ray: Enlarged bone structure, thickening of cortical bone, internal frontal hyperostosis, maxillary and frontal sinus enlargement, extension of the sella turcica

    MRI: to assess the pituitary mass

    Treatment and prognosis

    • Microsurgical trans-sphenoidal adenoma extirpation of anteropituitary adenoma
    • Osteotomies
    • Medical treatment: dopamine antagonists


    sources

    • Peters KM (Hrsg.) (2002)   Knochenkrankheiten