Gigantismo pituitario

Abstract

A boy with pituitary gigantism is presented. His clinical symptoms began at the age of 8 years with a growlh spurt and headaches, A year laler he developed tight amaurosis and he was admited to hospital. On physical examinalion his height was > p 95 for age, he had coarse facial features, big hands and feet, righl amaurosis and left quadrantopsy. Endocrine studies showed increased seium levels of growth noimone, which were nol suppressed by glucose; high somalomedin C and low thyroid hormones and cortisol. The computed tomographic scan showed a pituitary macroadenoma with suprasellar extension. Surgical Ireatmenl was indicated but his parents refused all kinds of therapy. A year later the palienl was readmitted to hospilal due lo intracraneal hypertension and bilateral amaurosis; nuclear magnetic resonance showed further tumoral growth. A necrotic and hemorragic pituitary tumor was resected by transphenoidal surgery. Postoperative course was salisfactory. The patieni is now on substitution treatment with thyroid hotmone and cortisol. A year after the surgical procedure he is doing well, and his serum growth hormone and somatomedin C levels are normal. There is no radiologic evidence of tumor regtowth,