Pathophysiology of Acromegaly

Introduction ACROMEGALY, a spectacular disorder of somatic growth and proportion, has fascinated endocrinologists for the past century and was the first pituitary disorder to be clinically recognized (1). Pituitary adenomas are common, being found in 15–25% of autopsies (2–4), but GH-secreting adenomas probably account for <1% of these. Tumors causing acromegaly are usually diagnosed clinically as their manifestations are so apparent during life. Unlike prolactin-secreting tumors and so-called nonfunctional tumors, GH-secreting adenomas are rarely discovered routinely at autopsy. Although about 2500 patients with pituitary tumors are diagnosed annually in the United States (1), the incidence of acromegaly remains undocumented. In a comprehensive community survey, Alexander et al. (5) studied a population of 3.1 million and concluded that a firm diagnosis of acromegaly had been made in 164 patients during an 11-year period. In half of these patients the diagnosis of acromegaly was made on clinical grounds ...