title: Patients cured of acromegaly do not experience improvement of their skull deformities.
abstract: OBJECTIVE
  Acromegaly is a rare disease that is associated with many co-morbidities. This condition also causes progressive deformity of the skull which includes frontal bossing and cranial thickening. Surgical and/or medical management can cure this condition in many patients, but it is not understood if patients cured of acromegaly experience regression of their skull deformities.
  
  
  METHODS
  We performed a retrospective analysis on patients treated at our dedicated pituitary center from 2009 to 2014. We looked at all MRI images taken during the treatment of these patients and recorded measurements on eight skull dimensions. We then analyzed these measurements for changes over time.
  
  
  RESULTS
  29 patients underwent curative treatment for acromegaly within our timeframe. The mean age for this population was 45.0 years old (range 19-70) and 55.2 % (n = 16) were female. All of these patients were treated with a transsphenoidal resection for a somatotropic pituitary adenoma. 9 (31.1%) of these patients required further medical therapy to be cured. We found statically significant variation in the coronal width of the sella turcica after therapy, which is likely attributable to changes from transsphenoidal surgery. None of the other dimensions had significant variation over time after cure.
  
  
  CONCLUSIONS
  Patients cured of acromegaly should not expect natural regression of their skull deformities. Our study suggests that both frontal bossing and cranial thickening do not return to normal after cure.
authors: Department of Neurological Surgery, University of California, 505 Parnassus Ave., M779, San Francisco, CA, 94143, USA. jonathan.rick@ucsf.edu.
authors: Jonathan W
authors: JW
authors: Rick
authors: Department of Neurological Surgery, University of California, 505 Parnassus Ave., M779, San Francisco, CA, 94143, USA.
authors: Arman
authors: A
authors: Jahangiri
authors: Department of Neurological Surgery, University of California, 505 Parnassus Ave., M779, San Francisco, CA, 94143, USA.
authors: Patrick M
authors: PM
authors: Flanigan
authors: Department of Neurological Surgery, University of California, 505 Parnassus Ave., M779, San Francisco, CA, 94143, USA.
authors: Manish K
authors: MK
authors: Aghi
mesh_terms: D000172:Acromegaly / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D005260:Female; D019382:Human Growth Hormone / Q000378:metabolism; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D012886:Skull / Q000002:abnormalities*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I
keywords: Acromegaly; Acromegaly outcomes; Growth hormone; Insulin-like growth factor 1; Pituitary adenoma; Skull base surgery