Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Dec 31;14(12):e247989.
doi: 10.1136/bcr-2021-247989.

Successful treatment of pituitary gigantism

Clara Cunha  1 , Catarina Saraiva  2 , Conceição Canas Marques  3 , João Sequeira Duarte  2
Affiliations
Case Reports

Successful treatment of pituitary gigantism

Clara Cunha et al. BMJ Case Rep. .

Abstract

Pituitary gigantism is extremely rare, resulting from excessive secretion of growth hormone (GH) before fusion of epiphysial growth plates. We report a case of a 13-year-old boy, who presented with increased statural growth and headaches since the age of 10 years. On physical examination, his height was 180.7 cm (+3.3 SD) and Tanner stage V. Investigation revealed increased levels of serum age-adjusted and sex-adjusted insulin-like growth factor 1 (IGF-1) and failure of GH suppression during an oral glucose tolerance test (OGTT). MRI of the sellar region revealed a pituitary macroadenoma. He underwent transsphenoidal surgery and histopathological evaluation revealed mammosomatotropic adenoma. Three months after surgery, IGF-1 normalised, nadir GH during OGTT was less than 1 ng/mL and no residual tumour was found on the MRI. Genetic testing identified a mutation in the AIP gene. This case emphasises the importance of early diagnosis of gigantism, as treatment delay increases long-term morbidity.

Keywords: endocrinology; pituitary disorders.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Growth chart.
Figure 2
Figure 2
MRI of the sellar region revealed a pituitary macroadenoma.
See this image and copyright information in PMC

References

    1. Bendor-Samuel OM, Pal A, Cudlip S, et al. . Pituitary gigantism: a rare learning opportunity. Arch Dis Child Educ Pract Ed 2020;105:111–6. 10.1136/archdischild-2018-316282 - DOI - PubMed
    1. Rhee N, Jeong K, Yang EM, et al. . Gigantism caused by growth hormone secreting pituitary adenoma. Ann Pediatr Endocrinol Metab 2014;19:96–9. 10.6065/apem.2014.19.2.96 - DOI - PMC - PubMed
    1. Eugster EA, Pescovitz OH. Gigantism. J Clin Endocrinol Metab 1999;84:4379–84. 10.1210/jcem.84.12.6222 - DOI - PubMed
    1. Nadhamuni VS, Iacovazzo D, Evanson J. GHRH secretion from a pancreatic neuroendocrine tumor causing gigantism in a patient with MEN1. Endocrinol Diabetes Metab Case Rep 2021:20–8. 10.1530/EDM-20-0208 - DOI - PMC - PubMed
    1. Barzaghi LR, Losa M, Capitanio JF, et al. . Pediatric pituitary adenomas: early and long-term surgical outcome in a series of 85 consecutive patients. Neurosurgery 2019;85:65–74. 10.1093/neuros/nyy204 - DOI - PubMed

Publication types