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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

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Acromegaly Type 1: A Representative Patient.

Daniel Cuevas-Ramos¹, Shlomo Melmed²

¹Neuroendocrinology Clinic, Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 14080 Mexico City, Mexico.

JCEM Case Reports

|April 18, 2024

Summary

This summary is machine-generated.

This case study highlights a 46-year-old woman diagnosed with acromegaly, a condition of excess growth hormone (GH). Despite subtle symptoms, early endocrine evaluation led to successful treatment and symptom resolution.

Keywords:

IGF-1 growth hormone insulin-like growth factor type 1 neuroendocrine tumor pituitary adenoma

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Area of Science:

Endocrinology
Neuroendocrinology
Pituitary Disorders

Background:

Acromegaly is a rare endocrine disorder caused by excessive growth hormone (GH) production, typically from a pituitary adenoma.
Diagnosis can be delayed due to subtle or non-specific symptoms, particularly in milder forms of the disease.

Observation:

A 46-year-old woman presented with chronic headaches and arthralgias, alongside unexplained increases in ring and shoe size.
Initial physical examination lacked classic acromegaly features like facial changes or significant acral enlargement.
Biochemical tests, including Insulin-like Growth Factor 1 (IGF-1) and an oral glucose tolerance test with GH measurement, confirmed hypersecretion of GH.

Findings:

Magnetic resonance imaging (MRI) revealed a pituitary microadenoma.
Surgical resection of the adenoma resulted in symptom resolution and biochemical control of the disease.
Histopathology confirmed a densely granulated somatotroph adenoma, consistent with type 1 acromegaly.

Implications:

This case underscores the importance of considering acromegaly even with mild or atypical presentations.
Awareness of acromegaly subtypes and their varied clinical manifestations is crucial for timely diagnosis.
Individualized therapeutic approaches are essential for managing acromegaly and improving patient outcomes.