Illustrative case of acromegaly caused by sparsely granulated somatotroph adenoma
DOI:
https://doi.org/10.25305/unj.342990Keywords:
acromegaly, growth hormone, pituitary macroadenoma, sparsely granulated somatotroph adenoma, endoscopic transsphenoidal surgeryAbstract
Background: Acromegaly arises from excessive growth hormone (GH) secretion, most often due to a pituitary adenoma. The disorder is typically indolent and may remain undiagnosed until mass-effect symptoms occur. Histological subtype, particularly the granulation pattern, influences clinical behavior and treatment response.
Case description: We describe the case of a 52-year-old man who presented with a two-year history of progressive enlargement of his hands and feet, facial coarsening, and recent-onset headache with visual blurring. Physical examination revealed classical acromegalic features and mild bitemporal hemianopia. Serum GH was markedly elevated (50 ng/mL) with other pituitary hormones within normal limits. MRI demonstrated a contrast-enhancing sellar–suprasellar lesion compressing the optic chiasm. The patient underwent endoscopic transnasal transsphenoidal excision of the mass. Histopathology confirmed a sparsely granulated somatotroph adenoma positive for PIT-1 and GH. Postoperative recovery was uneventful.
Conclusion: Sparsely granulated somatotroph adenomas exhibit greater invasiveness and reduced medical responsiveness than densely granulated variants. Early diagnosis and timely surgical resection remain crucial for visual preservation and endocrine control.
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