[Acromegaly--do we already know everything about treatment of the somatotroph pituitary adenomas?]

Acromegaly--do we already know everything about treatment of the somatotroph pituitary adenomas?--Acromegaly, an insidious neuroendocrine disorder, reduces life expectancy and leads to 3.5-fold increase in mortality. The main causes are cardiovascular, pulmonary and enhanced prevalence of deaths from malignancy. Successful therapy ought to normalize GH, IGF-I secretion, remove adenoma mass and its local pressure effects and preserve pituitary function to improve systemic morbidity and normalize mortality. The primary therapy for most patients with acromegaly caused by somatotroph pituitary adenoma is still transsphenoidal resection of the tumor. The results of the transsphenoidal surgery for pituitary adenoma for acromegaly depend on the volume of the tumor, its suprasellar and parasellar extension, especially to the cavernous sinus. The aim of this paper was to present the diagnostic criteria and principle therapy in these tumors. Our experience was based on the analysis of more than 150 patients operated on during the last five years and review of the literature.