ESPE Abstracts

Introduction: Acromegaly is a rare disorder, developed by overproduction of growth hormone (GH) and insulin-growth factor 1 (IGF-1), in most cases based on a pituitary adenoma. The increased IGF-1 and GH levels lead to the growth of acres and organs as well as metabolic changes. When manifesting before epiphyseal closure, a giant growth develops.

Case Report: A Ukrainian girl presented at the age of 14 years with enlargement of acres (nose, hands and feet), headache, fatigue, and primary amenorrhea. A cranial MRI was performed, which revealed a pituitary adenoma. Transsphenoidal tumor resection followed, although the tumor could not be completely removed. Postoperatively, the girl developed pituitary insufficiency and has since been treated with L-thyroxine, hydrocortisone, and estradiol. With additional central diabetes insipidus she receives a substitution with Minirin intranasal. The carpogram already showed closed epiphyseal joints, indicating the achievement of the individual final height. Until now, no signs of diabetes mellitus or other metabolic effects have been observed. Re-operation is currently not indicated. Drug treatment with the somatostatin analogue Lanreotide to suppress the production of growth hormone is ongoing. The patient is under close clinical and radiological control at our endocrinology center.

Conclusion: In the case of acromegaly, there is often a considerable delay in the diagnosis of an average of 7 years due to the rare occurrence and gradual physical changes. After completion of the growth phase, the coarsening of facial features and the growth of hands and feet should prompt further diagnosis in order to reduce morbidity and mortality through early treatment.