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Acromegaly (cont.)

Surgery

Surgery is the first treatment used for most people with excess growth hormone, regardless of the cause. Surgery brings about remission in some people, but not in all. People who are in remission after surgery usually need no further treatment.

  • The operation of choice for pituitary adenoma is transsphenoidal hypophysectomy.The tumor is removed via one of the nasal sinuses through an incision inside the nose.
  • If it is successful, this operation has 2 advantages. It rapidly improves symptoms caused by the tumor pressing on adjacent tissue, and it normalizes levels of growth hormone and IGF-I.
  • While this operation technically is not brain surgery, it requires a great deal of care to avoid injuring delicate tissues surrounding the pituitary. Success depends largely on the skill and experience of the surgeon.
  • Remission rates are about 80-85% for small adenomas (microadenomas) and 50-65% for large adenomas (macroadenomas).
  • The growth hormone and IGF-1 levels after surgery usually indicate whether further treatment is needed.
  • Some people require lifelong hormone replacement after pituitary surgery.

Follow-up

Acromegaly is a lifelong disease. Drug or radiation therapy typically goes on for several years. Even after successful therapy, you will need to see your health care provider regularly to have your levels of growth hormone and IGF-1checked.

Prevention

There is no known way to prevent acromegaly. Early detection is the best hope of preventing severe symptoms and complications.

Medically Reviewed by a Doctor on 12/23/2015
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Read What Your Physician is Reading on Medscape

Acromegaly »

Increased and unregulated growth hormone (GH) production, usually caused by a GH-secreting pituitary tumor (somatotroph tumor), characterizes acromegaly.

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