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Gigantism - Treatment

Alternative Names

Giantism

Treatment:

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

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.

Radiation therapy has also been used to bring growth hormone levels to normal. However, it can take 5 - 10 years for the full effects to be seen and almost always leads to low levels of other pituitary hormones.

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.

Expectations (prognosis):

Pituitary surgery is usually successful in limiting growth hormone production.

Complications:

  • Delayed puberty

Surgery and radiation can both lead to low levels of other pituitary hormones, which can cause:

Calling your health care provider:

Call your health care provider if your child has signs of excessive growth.

  • Reviewed last on: 11/23/2009
  • Ari S. Eckman, MD, Division of Endocrinology and Metabolism, Johns Hopkins School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Melmed S, Kleinberg D. Anterior pituitary. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR. Williams Textbook of Endocrinology. 11th ed. Philadelphia, PA: Saunders Elsevier; 2008:chap 8.

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