Acromegaly

A 34 year old man presented with diabetic ketoacidosis and coarse facial features, including frontal bossing, jaw protrusion, and malocclusion, which had developed over a decade. Clinical evaluation revealed elevated insulin like growth factor 1 (IGF-1: 478 ng/mL) and growth hormone (>65 ng/mL) levels, confirming acromegaly. MRI identified a 6.0 cm pituitary macroadenoma compressing the optic chiasm, causing bitemporal hemianopsia. Histopathology confirmed a growth hormone secre somatotroph adenoma. Initial transsphenoidal resection was followed by tumor regrowth, necessitating a second surgery. Postoperative management included monthly octreotide for residual disease and treatment of diabetes and hypertension. This case underscores the insidious progression of acromegaly and challenges in managing aggressive pituitary adenomas.

A 34 year old man presented with diabetic ketoacidosis and coarse facial features, including frontal bossing, jaw protrusion, and malocclusion, which had developed over a decade. Clinical evaluation revealed elevated insulin like growth factor 1 (IGF-1: 478 ng/mL) and growth hormone (>65 ng/mL) levels, confirming acromegaly. MRI identified a 6.0 cm pituitary macroadenoma compressing the optic chiasm, causing bitemporal hemianopsia. Histopathology confirmed a growth hormone secre somatotroph adenoma. Initial transsphenoidal resection was followed by tumor regrowth, necessitating a second surgery. Postoperative management included monthly octreotide for residual disease and treatment of diabetes and hypertension. This case underscores the insidious progression of acromegaly and challenges in managing aggressive pituitary adenomas.