Acromegaly

Gigantism and Acromegaly brings together pituitary experts, taking readers from bench research, to genetic analysis, clinical analysis, and new therapeutic approaches. This book serves as a reference for growth hormone over-secretion and its diagnosis and treatment for endocrinologists, pediatricians, internists, and neurosurgeons, and for geneticists. Pharmaceutical companies may use it as a reference for drug development and research. Students, residents and fellows in medicine and endocrinology and genetics will also find it valuable as it provides a single up-to-date review of the molecular biology of gigantism and acromegaly as well as recommended approaches to evaluation and management. Acromegaly is a rare pituitary disorder that slowly changes its adult victim’s appearance over time: larger hands and feet, bigger jaw, forehead, nose, and lips. Generally, a benign pituitary tumor is the cause and symptoms of acromegaly can vary from patient to patient, making a diagnosis difficult and prolonging suffering for years. Early detection is key in the management of acromegaly as the pathologic effects of increased growth hormone (GH) production are progressive and can be life-threatening as the result of associated cardiovascular, cerebrovascular, and respiratory disorders and malignancies. Accessible, up-to-date overview of the characteristics, state-of-the-art diagnostic procedures, and management of acromegaly and gigantism Provides a unique compendium of endocrinology, genetics, clinical diagnosis and therapeutics Contains contributions from internationally known experts who have treated patients with acromegaly and gigantism

Currently, surgical management provides the definitive treatment of choice for most pituitary adenomas, craniopharyngiomas and meningiomas of the sellar region. The elegant minimally invasive transnasal endoscopic approach to the sella turcica and the anterior skull base has added a new dimension of versatility to pituitary surgery and can be adapted to many lesions in the region. In this multi-author book with numerous color illustrations the main aspects of the endonasal endoscopic approach to the skull base are presented, starting with a clear description of the endoscopic anatomy, the panoramic view afforded by the endoscope and the development of effective instruments and adjuncts. After the diagnostic studies, the strictly surgical features are considered in detail. The standard technique is described and particular aspects are treated, including the new extended approaches to the cavernous sinus, spheno-ethmoid planum and clival regions.

Acromegaly is a relatively rare disease caused by a pituitary tumour that stimulates overproduction of growth hormone. If untreated, acromegaly leads to substantially increased morbidity and mortality. Even in the shorter term, the effects on patients are severe and distressing, including increases in hand and foot size, changing facial features and carpal tunnel syndrome.

The pituitary, albeit a small gland, is known as the "master gland" of the endocrine system and contributes to a wide spectrum of disorders, diseases, and syndromes. Since the publication of the second edition of The Pituitary, in 2002, there have been major advances in the molecular biology research of pituitary hormone production and action and there is now a better understanding of the pathogenesis of pituitary tumors and clinical syndromes resulting in perturbation of pituitary function. There have also been major advances in the clinical management of pituitary disorders. Medical researchers and practitioners now better understand the morbidity and mortality associated with pituitary hormone hyposecretion and hypersecretion. Newly developed drugs, and improved methods of delivering established drugs, are allowing better medical management of acromegaly and prolactinoma. These developments have improved the worldwide consensus around the definition of a "cure" for pituitary disease, especially hormone hypersecretion, and hence will improve the success or lack of success of various forms of therapy. It is therefore time for a new edition of The Pituitary. The third edition will continue to be divided into sections that summarize normal hypothalamic-pituitary development and function, hypothalamic-pituitary failure, and pituitary tumors; additional sections will describe pituitary disease in systemic disorders and diagnostic procedures, including imaging, assessment of the eyes, and biochemical testing. The first chapter will be completely new – placing a much greater emphasis on physiology and pathogenesis. Two new chapters will be added on the Radiation and Non-surgical Management of the Pituitary and Other Pituitary Lesions. Other chapters will be completely updated and many new author teams will be invited. The second edition published in 2002 and there have been incredible changes in both the research and clinical aspects of the pituitary over the past 8 years – from new advances in growth hormones to pituitary tumor therapy. Presents a comprehensive, translational source of information about the pituitary in one reference work Pituitary experts (from all areas of research and practice) take readers from the bench research (cellular and molecular mechanism), through genomic and proteomic analysis, all the way to clinical analysis (histopathology and imaging) and new therapeutic approaches Clear presentation by endocrine researchers of the cellular and molecular mechanisms underlying pituitary hormones and growth factors as well as new techniques used in detecting lesions (within the organ) and other systemic disorders Clear presentation by endocrinologists and neuroendocrine surgeons of how imaging, assessment of the eyes, and biochemical testing can lead to new therapeutic approaches

Now in its second edition, the Oxford Textbook of Endocrinology and Diabetes is a fully comprehensive, evidence-based, and highly-valued reference work combining basic science with clinical guidance, and providing first rate advice on diagnosis and treatment.

Reviewing the most current literature, this text is a guide to medical decision-making regarding the diagnosis and treatment of patients with acromegaly. The scope of the book is comprehensive, covering all relevant facets of acromegaly, beginning with a history of the disorder and a review of the somatotrophic axis. Etiology is then discussed, including growth hormone secreting pituitary adenomas and other neuroendocrine tumors. Subsequent chapters present imaging modalities and diagnosis via radiology and clinical findings, as well as comorbid symptoms such as sleep apnea, musculoskeletal considerations, cardiovascular disorders, cancer and diabetes. Both medical and surgical management chapters describe each in detail, including radiotherapy, transsphenoidal surgery, somatostatin analogues and dopamine agonists. Concluding chapters present long-term follow-up as well as an extended selected patient story detailing life with the disease. Bringing together the latest in endocrinologic and neurosurgical evidence and practice, Acromegaly will be the go-to resource for this challenging condition for years to come.

The manuscripts in this volume were contributed by the speakers invited to the Acromegaly Centennial Symposium held in San Francisco, California in July 1986. The meeting was organized to commemorate the description of acromegaly by the French physician Pierre Marie, in 1886. The members of the Scientific Committee spent many hours assisting us in ensuring an outstanding meeting. The support of Serono Symposia, USA in all phases of the planning and execution of the meeting was sincerely appreciated and was highly professional. Special recognition roust be extended to Professor Roger Guillemin of the Salk Institute, whosp interest in medical history led him to devote a great deal of time and personal expense in obtaining information about the life of Pierre Marie. Dr. GuilIemin's presentation on the life and times of Marie was an extraordinary overview of the cultural, social, and scientific backgrounds in which Marie came to describe the disease, acromegaly. Dr. Guillemin' s findings, which were presented at the main banquet in a splendid audiovisual presentation, were clearly the highlight of the meeting and will long be remembered by the attendees. We were also honored by the presence of Dr. Martine Pierre Marie Granier, the great-granddaughter of Pierre Harie. In her address at the banquet, Dr. Granier provided several delightful and intimate vignettes concerning Pierre Marie, using old family records and photographs. The Scientific Committee wishes to extend its gratitude to Dr. Granier for adding immeasurably to the historical atmosphere of the meeting.

The first two years of life represent a transition period when growth changes from predominantly growth hormone (GH) independent to GH dependent. This book, Growth Disorders and Acromegaly, includes two parts. The first part consists of five chapters that illustrate the nature, causes, types, signs, and symptoms of GH deficiency (GHD) and fetal growth restriction. It describes the impact of GH and its deficiency on different biological systems in children and adults. Also, this book assesses the role of human GH (hGH) and insulin-growth factor1 (IGF-1) gene families during pregnancy. This book offers several novel insights of GH in male reproductive health. The second part consists of three chapters that show the pegvisomant, colorectal neoplasms in acromegaly, epidemiology and underlying mechanisms, and the surgical managements of acromegaly. Finally, this book will be of interest to scientists, embryologists, neuroendocrinologists, neurotoxicologists, and physicians who follow recent developments in the field of growth disorders.