Acromegaly in an Elderly Woman

Area of Science:

• Endocrinology
• Neurosurgery
• Oncology

Background:

• Pituitary adenomas are common intracranial tumors.
• Macroadenomas can cause significant clinical issues due to hormone excess or mass effects.
• Diagnosis in older adults is often delayed, with symptoms misattributed to aging.

Purpose of the Study:

• To highlight the importance of suspecting acromegaly in elderly patients with unexplained physical changes.
• To emphasize the role of endocrine evaluation and imaging in diagnosing pituitary macroadenomas.
• To underscore the necessity of timely surgical intervention for pituitary macroadenomas.

Main Methods:

• Case report of a 61-year-old woman with symptoms of acromegaly.
• Laboratory investigations for growth hormone (GH) and insulin-like growth factor-1 (IGF-1).
• Magnetic resonance imaging (MRI) for pituitary macroadenoma detection.
• Endonasal endoscopic transsphenoidal surgery for tumor resection.

Main Results:

• The patient presented with coarsening facial features and acral enlargement.
• Elevated GH (18.9 ng/mL) and IGF-1 (865.6 ng/mL) confirmed acromegaly.
• A pituitary macroadenoma (1.3 × 2.5 × 1.0 cm) was identified on MRI.
• Successful surgical resection of the macroadenoma was performed.

Conclusions:

• Acromegaly should be suspected in elderly patients with unexplained acral and facial changes.
• Comprehensive endocrine assessment and advanced imaging are vital for accurate diagnosis.
• Prompt surgical treatment of pituitary macroadenomas prevents disease progression.