Acromegaly: Role of Surgery in the Therapeutic Armamentarium
Acromegaly is a complex disease that requires the intervention of a multidisciplinary team. The most frequent clinical manifestations are growing of distal parts of the body and some areas of the face. Patients may also present arterial hypertension, diabetes mellitus, colonic polyps, cardiomegaly,...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2012/306094 |
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| author | Gerardo Guinto Miguel Abdo Erick Zepeda Norma Aréchiga Moisés Mercado |
| author_facet | Gerardo Guinto Miguel Abdo Erick Zepeda Norma Aréchiga Moisés Mercado |
| author_sort | Gerardo Guinto |
| collection | DOAJ |
| description | Acromegaly is a complex disease that requires the intervention of a multidisciplinary team. The most frequent clinical manifestations are growing of distal parts of the body and some areas of the face. Patients may also present arterial hypertension, diabetes mellitus, colonic polyps, cardiomegaly, neurological and endocrine changes secondary to the presence of a GH-secreting tumor in pituitary or extrapituitary origin, or eutopic hypothalamic GHRH hypersecretion and peripheral GHRH hypersecretion. Surgery is the first treatment used for most patients, regardless of the cause. In the great majority of cases, pituitary tumor can be removed through a transsphenoidal approach. Craniotomy is reserved for those cases with giant tumors, particularly when they grow toward the middle or posterior cranial fossa. Best surgical results are obtained when the tumor is confined into the sella turcica or if it has a regular suprasellar extension. When the disease cannot be controlled with surgery, medical treatment is indicated. Somatostatin analogues are included as the first line of medication, followed by dopamine agonist and growth hormone receptors antagonists. Radiation therapy can be also indicated in two main forms for residual tumor with medically refractory patients: radiosurgery for small tumors or fractionated stereotactic radiotherapy for larger ones. |
| format | Article |
| id | doaj-art-56d117e37bfd4cc4959ae76072a10553 |
| institution | Kabale University |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Endocrinology |
| spelling | doaj-art-56d117e37bfd4cc4959ae76072a105532025-02-03T06:07:18ZengWileyInternational Journal of Endocrinology1687-83371687-83452012-01-01201210.1155/2012/306094306094Acromegaly: Role of Surgery in the Therapeutic ArmamentariumGerardo Guinto0Miguel Abdo1Erick Zepeda2Norma Aréchiga3Moisés Mercado4Department of Neurosurgery, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, 06720 Mexico City, DF, MexicoDepartment of Neurosurgery, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, 06720 Mexico City, DF, MexicoDepartment of Neurosurgery, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, 06720 Mexico City, DF, MexicoCentro Neurológico ABC, 05300 Mexico City, DF, MexicoDepartment of Endocrinology, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, 06720 Mexico City, DF, MexicoAcromegaly is a complex disease that requires the intervention of a multidisciplinary team. The most frequent clinical manifestations are growing of distal parts of the body and some areas of the face. Patients may also present arterial hypertension, diabetes mellitus, colonic polyps, cardiomegaly, neurological and endocrine changes secondary to the presence of a GH-secreting tumor in pituitary or extrapituitary origin, or eutopic hypothalamic GHRH hypersecretion and peripheral GHRH hypersecretion. Surgery is the first treatment used for most patients, regardless of the cause. In the great majority of cases, pituitary tumor can be removed through a transsphenoidal approach. Craniotomy is reserved for those cases with giant tumors, particularly when they grow toward the middle or posterior cranial fossa. Best surgical results are obtained when the tumor is confined into the sella turcica or if it has a regular suprasellar extension. When the disease cannot be controlled with surgery, medical treatment is indicated. Somatostatin analogues are included as the first line of medication, followed by dopamine agonist and growth hormone receptors antagonists. Radiation therapy can be also indicated in two main forms for residual tumor with medically refractory patients: radiosurgery for small tumors or fractionated stereotactic radiotherapy for larger ones.http://dx.doi.org/10.1155/2012/306094 |
| spellingShingle | Gerardo Guinto Miguel Abdo Erick Zepeda Norma Aréchiga Moisés Mercado Acromegaly: Role of Surgery in the Therapeutic Armamentarium International Journal of Endocrinology |
| title | Acromegaly: Role of Surgery in the Therapeutic Armamentarium |
| title_full | Acromegaly: Role of Surgery in the Therapeutic Armamentarium |
| title_fullStr | Acromegaly: Role of Surgery in the Therapeutic Armamentarium |
| title_full_unstemmed | Acromegaly: Role of Surgery in the Therapeutic Armamentarium |
| title_short | Acromegaly: Role of Surgery in the Therapeutic Armamentarium |
| title_sort | acromegaly role of surgery in the therapeutic armamentarium |
| url | http://dx.doi.org/10.1155/2012/306094 |
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