Acromegales and Giants

Growth hormone-secreting adenomas are the usual cause of acromegaly. Despite the deformities of the face and of the extremities related to GH excess, the diagnosis is statistically made 4 or 5 years after the onset of the disease. The patient will be a giant if the disease occurs before the closure of epiphyses. Most GH-secreting PitNETs are macroadenomas and extent downwards. Compression of the optic chiasm is exceptional. Two pathologic subtypes are described. The densely granulated tumors, the most frequent, demonstrate a characteristic T2W hypointense signal. These rarely invade the cavernous sinus and react favorably to treatment with somatostatin analogs. The sparsely granulated tumors are larger and have more variable characteristics.