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Surgery for acromegaly: Indications and goals

Journal

FRONTIERS IN ENDOCRINOLOGY
Volume 13, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fendo.2022.924589

Keywords

acromegaly; adenoma; pituitary; endonasal; endoscopic; skull-base; transnasal

Funding

  1. Nell W. and William S. Elkin Research Fellowship in Oncology, Winship Cancer Institute, Emory University Hospital, Atlanta, GA
  2. National Center for Advancing Translational Sciences of the National Institutes of Health [UL1TR002378, TL1TR002382]

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Acromegaly is a disease caused by excessive levels of growth hormone, usually due to hormone-secreting pituitary adenomas, leading to adverse effects in multiple systems. Diagnosis involves measuring serum growth hormone and IGF-1 levels and obtaining an MRI to evaluate pituitary adenoma function. Complete surgical resection of the growth hormone-secreting adenoma is the preferred treatment for acromegaly, aiming for biochemical remission. Medical and radiation therapies are available if biochemical cure is not achieved after surgery.
Acromegaly is a disease that occurs secondary to high levels of GH, most often from a hormone-secreting pituitary adenoma, with multisystem adverse effects. Diagnosis includes serum GH and IGF-1 levels, and obtaining an MRI pituitary protocol to assess for a functional pituitary adenoma. Attempted gross total resection of the GH-secreting adenoma is the gold standard in treatment for patients with acromegaly for a goal of biochemical remission. Medical and radiation therapies are available when patients do not achieve biochemical cure after surgical therapy.

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