How can you get gigantism

Only approximately six new cases occur each year in the United Kingdom. Gigantism is generally not inherited. There are, however, a number of rare conditions associated with gigantism such as McCune Albright syndrome , neurofibromatosis, Carney complex and multiple endocrine neoplasia type 1 and 4.

Gigantism seen in these conditions is still rare. Recently, a new possible cause of pituitary tumours in families has been suggested, particularly tumours secreting growth hormone or prolactin. These often occur at a relatively young age and are thought to be caused by a genetic mutation. If gigantism is suspected, the diagnosis is usually confirmed by taking blood tests to measure the levels of growth hormone and insulin-like growth factor 1 IGF1 circulating in the blood.

IGF1 is released into the blood primarily by the liver in response to growth hormone. This involves having a glucose drink followed by blood samples obtained periodically over 2 hours to estimate the growth hormone level. Normally, the amount of growth hormone in the blood is reduced by the glucose drink. However, if a person suffers from gigantism, the growth hormone level remains high. A magnetic resonance imaging MRI scan is undertaken to assess the size of the pituitary gland and the degree of compression of surrounding structures.

These investigations are all performed as an outpatient. Gigantism requires early diagnosis and treatment in order to prevent excess height and to improve life expectancy. If it is left untreated, gigantism is associated with significant complications and an increased death rate of around twice the normal average for the population.

The aim is to reduce growth hormone levels below 2. Surgery is usually the first recommended treatment and is usually performed as a planned hospital admission. The operation aims to remove or reduce the size of the tumour to lower growth hormone levels and reduce the pressure on the optic nerve needed for your eyes to work and other nearby areas.

Radiation therapy can be offered as an outpatient if surgery has not provided a complete cure. Radiation therapy may not only reduce growth hormone and IGF1 levels but can also be effective in controlling tumour growth. The main types of drugs available to reduce growth hormone levels may lower growth hormone levels, block growth hormone action and possibly reduce the size of the tumour. Your doctor will conduct a physical examination and ask you about your medical history and symptoms.

Your doctor may order an oral glucose tolerance test OGTT to confirm the diagnosis. One method we use for detecting pituitary tumors is using sophisticated magnetic resonance imaging MRI of the pituitary gland. Typically, more than one specialist is involved in the management of pituitary adenomas. At the Pituitary Tumor Program, your medical team includes a special endocrinologist called a neuro-endocrinologist who has specific expertise in the treatment of acromegaly and gigantism.

Surgically removing the selected tumors offers the best chance for cure. You should seek the care of an experienced neurosurgeon that performs a high volume of pituitary surgeries every year. Our neurosurgeons practice the latest surgical techniques, such as the expanded, endoscopic endonasal approach, allowing us to cure pituitary tumors that were previously deemed unresectable unable to be removed surgically.

Long-term cure rates after transsphenoidal pituitary tumor surgery:. However, both medical and surgical therapies may be required to control acromegaly. For some patients, surgery or medication is not sufficient to control the acromegaly. In these cases, doctors may recommend stereotactic radiosurgery. Stereotactic radiosurgery is a technique in which doctors aim a highly focused dose of radiation to the tumor.

The radiation beam is designed to target only the tumor. Acromegaly: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. PMID: www. Melmed S. Endocrinology: Adult and Pediatric. Philadelphia, PA: Elsevier Saunders; chap Editorial team. Other causes include: Genetic disease that affects the skin color pigmentation and causes benign tumors of the skin, heart, and endocrine hormone system Carney complex Genetic disease that affects the bones and skin pigmentation McCune-Albright syndrome Genetic disease in which one or more of the endocrine glands are overactive or form a tumor multiple endocrine neoplasia type 1 or type 4 Genetic disease that forms pituitary tumors Disease in which tumors form on the nerves of the brain and spine neurofibromatosis If excess GH occurs after normal bone growth has stopped end of puberty , the condition is known as acromegaly.

Other symptoms include: Delayed puberty Double vision or difficulty with side peripheral vision Very prominent forehead frontal bossing and a prominent jaw Gaps between the teeth Headache Increased sweating Irregular periods menstruation Joint pain Large hands and feet with thick fingers and toes Release of breast milk Sleep problems Thickening of the facial features Weakness Voice changes. Exams and Tests. The health care provider will perform a physical exam and ask about the child's symptoms.

For pituitary tumors, surgery can cure many cases.