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GIGANTISM AND ACROMEGALY THROUGH HISTORY.

Maša Malenica1, Tena Trbojević1, Stjepan Herceg1

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Gigantism and acromegaly, conditions of excess growth hormone, have evolved from myth to medical understanding. Surgical treatment remains optimal despite advances in diagnosis and therapies.

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Area of Science:

  • Endocrinology
  • Medical History
  • Neurosurgery

Background:

  • Gigantism and acromegaly were historically viewed as mythical conditions before medical recognition.
  • Early medical descriptions date back to the 16th century, with formal appellation in the 19th century.
  • Neurosurgeons became involved in the early 20th century, linking pituitary adenomas to these conditions.

Purpose of the Study:

  • To trace the historical progression of understanding gigantism and acromegaly.
  • To highlight key milestones in diagnosis and treatment.
  • To emphasize the current optimal therapeutic strategies.

Main Methods:

  • Historical review of medical literature and clinical observations.
  • Tracing the evolution of diagnostic tools and understanding of growth hormone (GH) and insulin-like growth factor (IGF-I).
  • Analysis of treatment modalities including surgery, radiotherapy, and pharmacotherapy.

Main Results:

  • Recognition evolved from mythical descriptions to scientific understanding, identifying growth hormone (GH) hypersecretion as the cause.
  • Surgical intervention, particularly transsphenoidal surgery for pituitary adenomas, has been a cornerstone since the early 20th century.
  • Pharmacotherapies like dopamine agonists, somatostatin analogs, and GH receptor blockers were introduced after 1970.

Conclusions:

  • Despite significant advancements in medical science and endocrinology, surgical treatment remains the primary and most effective approach for gigantism and acromegaly.
  • Continued progress in basic sciences and clinical endocrinology is crucial for improving pathogenesis comprehension, diagnostics, and treatment.
  • The historical journey underscores the immense progress in medicine and science in understanding and managing these conditions.