title: Gigantism caused by growth hormone secreting pituitary adenoma.
abstract: Gigantism indicates excessive secretion of growth hormones (GH) during childhood when open epiphyseal growth plates allow for excessive linear growth. Case one involved a 14.7-year-old boy presented with extreme tall stature. His random serum GH level was 38.4 ng/mL, and failure of GH suppression was noted during an oral glucose tolerance test (OGTT; nadir serum GH, 22.7 ng/mL). Magnetic resonance imaging (MRI) of the brain revealed a 12-mm-sized pituitary adenoma. Transsphenoidal surgery was performed and a pituitary adenoma displaying positive immunohistochemical staining for GH was reported. Pituitary MRI scan was performed 4 months after surgery and showed recurrence/residual tumor. Medical treatment with a long-acting somatostatin analogue for six months was unsuccessful. As a result, secondary surgery was performed. Three months after reoperation, the GH level was 0.2 ng/mL and insulin-like growth factor 1 was 205 ng/mL. Case two involved a 14.9-year-old boy, who was referred to our department for his tall stature. His basal GH level was 9.3 ng/mL, and failure of GH suppression was reported during OGTT (nadir GH, 9.0 ng/mL). Pituitary MRI showed a 6-mm-sized pituitary adenoma. Surgery was done and histopathological examination demonstrated a pituitary adenoma with positive staining for GH. Three months after surgery, the GH level was 0.2 ng/mL and nadir GH during OGTT was less than 0.1 ng/mL. Pituitary MRI scans showed no residual tumor. We present two cases of gigantism caused by a GH-secreting pituitary adenoma with clinical and microscopic findings.
authors: Department of Pediatrics, Chonnam National University Hospital & Medical School, Gwangju, Korea.
authors: Noorisaem
authors: N
authors: Rhee
authors: Department of Pediatrics, Chonnam National University Hospital & Medical School, Gwangju, Korea.
authors: Kumi
authors: K
authors: Jeong
authors: Department of Pediatrics, Chonnam National University Hospital & Medical School, Gwangju, Korea.
authors: Eun Mi
authors: EM
authors: Yang
authors: Department of Pediatrics, Chonnam National University Hospital & Medical School, Gwangju, Korea.
authors: Chan Jong
authors: CJ
authors: Kim
keywords: Gigantism; Growth hormone; Pituitary adenoma