title: Diagnosis and management of acromegaly: giant invasive adenoma.
abstract: Acromegaly is a rare disorder caused by excessive growth hormone. Majority of acromegaly are due to pituitary adenoma. It is estimated that 5% of pituitary adenoma become invasive and may grow to gigantic sizes (>4 cm in diameter). We would like to describe a man with giant invasive adenoma. We describe the case of 52-year-old man with acromegaly. The patient was presented to medical care because of hemichorea. He also had visual field defect, uncontrolled diabetes, and dyslipidemia. Hormonal profile showed increment of GH 2-hour after a standard 75-g oral glucose load and of high IGF-1 level with low level of FSH and LH. The next was performed by pituitary imaging. Magnetic resonance imaging showed a macroadenoma with diameter 2.3x3.5x6.6 cm3 that fills the sella tursica, and enlarges into suprasella, genu of corpus collosum, and invades third ventricle. This report describes a rare case of acromegalic patient with giant invasive adenoma. This could be a demonstrative case and lesson for diagnosis and manage acromegalic patient.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, University of Indonesia-Cipto Mangunkusumo Hospital. Jl. Diponegoro no. 71, Jakarta, Indonesia. rahmat_cahyanur@yahoo.com
authors.forename: Rahmat
authors.initials: R
authors.lastname: Cahyanur
authors.forename: Wawan
authors.initials: W
authors.lastname: Setyawan
authors.forename: Dedy G
authors.initials: DG
authors.lastname: Sudrajat
authors.forename: Susie
authors.initials: S
authors.lastname: Setyowati
authors.forename: Dyah
authors.initials: D
authors.lastname: Purnamasari
authors.forename: Pradana
authors.initials: P
authors.lastname: Soewondo
mesh_terms: D000172:Acromegaly / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D001971:Bromocriptine / Q000627:therapeutic use; D005640:Follicle Stimulating Hormone; D013006:Growth Hormone; D006727:Hormone Antagonists / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007334:Insulin-Like Growth Factor I; D007986:Luteinizing Hormone; D008279:Magnetic Resonance Imaging; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery
chemical_list: D006727:Hormone Antagonists; D007004:Hypoglycemic Agents; D001971:Bromocriptine; D007334:Insulin-Like Growth Factor I; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D013006:Growth Hormone; D008687:Metformin