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2. Treatments
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3. In pituitary tumors with well-defined borders, surgery is the treatment of choice and can cure many cases.

4. What is the best case scenario for treatment?

5. 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 release.

6. What happens if surgery is not an option?

7. Dopamine agonists (bromocriptine mesylate, cabergoline) have also been used to reduce growth hormone release, but these are generally less effective. Pegvisomant, a medication that blocks the effect of growth hormone, may be used.

8. What medications are used for treatment?

9. Radiation therapy has also been used to bring growth hormone levels to normal. However, it can take years for the full effects to be seen and this almost always leads to low levels of other pituitary hormones.

10. What extreme measure would be taken?

11. Radiation has also been linked to learning disabilities, obesity, and emotional changes in children. Most experts will use radiation only if surgery and medication fail.

12. Why would radiation be a bad treatment?

13. What would be one test for determining gigantism?

14. CT or MRI scan of the head showing pituitary tumor

15. High prolactin levels

16. What would be another test for gigantism?

17. Increased insulin growth factor-I (IGF-I) levels

18. Test including insulin?

19. Failure to suppress serum growth hormone (GH) levels after an oral glucose challenge (maximum 75g)

20. What would be a major test for gigantism?

21. Cortisol
Estradiol (girls)
Testosterone (boys)
Thyroid hormone

22. Damage to the pituitary gland may lead to what?

23. Double vision or difficulty with side (peripheral) vision
Delayed puberty
Double vision or difficulty with side (peripheral) vision

24. What are two symptoms of gigantism?

25. Frontal bossing and a prominent jaw
Headache

26. What are two major signs of gigantism?

27. Increased sweating
Irregular periods (menstruation)

28. What are two odd symptoms of gigantism?

29. Large hands and feet with thick fingers and toes
Release of breast milk

30. What are two noticeable symptoms of gigantism?

31. Thickening of the facial features
Weakness

32. What are some other symptoms of gigantism?

33. The most common cause of too much growth hormone release is a noncancerous (benign) tumor of the pituitary gland.

34. What is gigantism?

35. Acromegaly

36. What is another name for gigantism?

37. Gigantism is very rare.

38. Why don't we see a lot of gigantism?

39. Carney complex
McCune-Albright syndrome (MAS)
Multiple endocrine neoplasia type 1 (MEN-1)
Neurofibromatosis

40. What are some other causes of gigantism?

41. If excess growth hormone occurs after normal bone growth has stopped, the condition is known as acromegaly.

42. What happens to the growth hormone?

43. Pituitary surgery is usually successful in limiting growth hormone production.

44. What is the outlook on gigantism surgery?

45. Delayed puberty

46. What would a possible complication be?

47. The main difference between the two disorders is that overproduction of GH in acromegaly occurs in adulthood after the bone growth plates have closed, so it does not result in the same extreme growth as with gigantism.

48. What is the difference between gigantism and acromegaly?

49. Adrenal insufficiency Diabetes insipidus (rarely) Hypogonadism
Hypothyroidism

50. How would radiation and surgery be harmful?

51. If left untreated, gigantism can lead to a variety of complications, such as heart disease, unusual height, delayed puberty, and double vision.

52. What would happen of gigantism were not treated?