Related Experiment Video
Updated: May 15, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Where is the culprit? A case of acromegaly that defied the management algorithm
Celito A Tamban1, Mark Anthony S Sandoval, Frances Lina Lantion-Ang
1Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, Philippine General Hospital, University of the Philippines Manila Manila, Philippines. celito_md@yahoo.com
Abstract:
A 30-year-old Filipino man presented with a 11-year history of coarse facial features and progressive enlargement of hands and feet. Initial work-up revealed elevated insulin-like growth factor-1 and non-suppressible growth hormone level after 75 g glucose challenge test. Initial cranial MRI performed in the year 2010 showed absence of pituitary adenoma. The patient was lost to follow-up. He again consulted in the year 2011 and a repeat cranial MRI and a dedicated pituitary MRI were performed and both did not reveal any pituitary mass. Further investigation included chest and abdominal CT scan, both of which did not show any neoplasm. At present, there has been no practice guideline on the management of acromegalic patients on whom the identifiable source cannot be found. The patient was given the option to undergo surgical exploration of the pituitary gland or medical treatment with somatostatin analogues. He decided to undergo surgery but has not given consent for the procedure.
Related Concept Videos
Cushing Syndrome II: Pathophysiology
Cushing Syndrome I: Introduction
Cardiomyopathy III: Hypertrophic Cardiomyopathy
Adrenal Gland Disorders
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
Hyperglycemia
Cardiomyopathy IV: Restrictive Cardiomyopathy
