Which physical findings are characteristic of gigantism in hyperpituitarism?

Updated: Oct 24, 2016
  • Author: Alicia Diaz-Thomas, MD, MPH; Chief Editor: Robert P Hoffman, MD  more...
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Answer

In patients with gigantism, all growth parameters are affected, although not necessarily symmetrically. GH excess over time is characterized by progressive cosmetic disfigurement and systemic organ manifestations. The following may be noted:

  • Tall stature

  • Mild-to-moderate obesity (common)

  • Macrocephaly, which may precede linear growth

  • Exaggerated growth of the hands and feet with thick fingers and toes

  • Coarse facial features, including frontal bossing and prognathism

  • Hyperhidrosis

  • Menstrual irregularities

  • Peripheral neuropathies (eg, carpal tunnel syndrome)

  • Cardiovascular disease: Prolonged GH excess can result in cardiac hypertrophy, hypertension, and left ventricular hypertrophy.

  • Tumors: Although benign tumors, including uterine myomas, prostatic hypertrophy, colon polyps, and skin tags, may be frequently encountered in acromegaly, the documentation of the overall prevalence of malignancies in patients with acromegaly remains controversial.

  • Endocrinopathies: Frequently associated endocrinopathies include hypogonadism, diabetes, decreased glucose tolerance, and hyperprolactinemia. OSA has been reported in up to half of patients with acromegaly, particularly those who are obese or older than 50 years.


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