A 42-Year-Old Man with Acromegaly and Related Complications: A Case Report Highlighting the Importance of Early Diagnosis of a Rare Condition and Its Further Management

Abstract

Background: Acromegaly is a rare and often underdiagnosed disorder caused mainly by excessive growth hormone secretion from a pituitary adenoma. Prolonged elevation of growth hormone and insulin-like growth factor-1 can lead to multiple cardiovascular, respiratory, metabolic, musculoskeletal, neurological, and neoplastic complications.

Case Presentation: A 42-year-old man presented with progressive physical and emotional changes over approximately 18 years, including enlargement of the hands and feet, coarse facial features, deepening of the voice, increased height and weight, headache, fatigue, and progressive musculoskeletal pain. Acromegaly was suspected after an incidental finding of an enlarged pituitary gland on MRI performed for chronic rhinosinusitis. Laboratory evaluation demonstrated markedly elevated insulin-like growth factor-1 and growth hormone levels. The patient underwent transsphenoidal resection of the pituitary gland followed by radiotherapy and treatment with octreotide. However, he discontinued octreotide after four months because of poor compliance.

Conclusion: This case highlights the insidious progression of acromegaly and the importance of early recognition of its subtle clinical manifestations. Early diagnosis and appropriate multimodal management may help reduce irreversible skeletal changes, prevent complications, and improve overall health outcomes.