Gigantism

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Endocrine glands

Giantism

In pituitary tumors with well-defined borders, surgery is the treatment of choice and is curative is about 80% of cases.

For situations in which surgery cannot completely remove the tumor, medication is the treatment of choice. The most effective medications are somatostatin analogs (such as octreotide or long-acting lanreotide), which reduce growth hormone secretion.

Dopamine agonists (bromocriptine mesylate, cabergoline) have also been used to reduce growth hormone secretion, but these are generally less effective. A medication that blocks the effect of growth hormone, pegvisomant, has recently become available.

Radiation therapy has also been used to normalize growth hormone levels. However, it can take 5-10 years for the full effects to be seen and is almost always associated with deficiencies in other pituitary hormones. In addition, radiation has been associated with learning disabilities, obesity, and emotional changes in children. Most experts will use radiation only if surgery and medication fail.

Pituitary surgery is usually successful in limiting growth hormone production.

• The development of secondary sexual characteristics may be delayed.
• Surgery and radiation can both lead to deficiencies in other pituitary hormones, causing hypothyroidism, adrenal insufficiency, hypogonadism, and (rarely) diabetes insipidus.

Call your health care provider if signs of excessive growth during childhood are present.

Review Date: 08/11/2006
Reviewed By: Robert Hurd, MD, Department of Biology, College of Arts and Sciences, Xavier University, Cincinnati, OH. Review provided by VeriMed Healthcare Network.