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Acromegaly is a disorder that occurs when high levels of growth hormone cause bones and soft tissues to grow excessively.

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What is Acromegaly?

Acromegaly is a disorder that occurs when high levels of growth hormone cause bones and soft tissues to grow excessively.

This hormonal disorder develops when your pituitary gland, located at the base of your skull, produces excessive amounts of growth hormone during adulthood, leading to an increase in bone size, particularly of the hands, feet, and face. Because the onset of symptoms occurs gradually, this condition is often misdiagnosed.

Who is at risk for acromegaly?

Acromegaly is typically diagnosed in middle-aged adults, but it can develop at any age. When growth hormone-producing tumors develop in childhood, the condition is called “gigantism," rather than acromegaly.

Causes of acromegaly

Acromegaly is typically caused by a tumor in the pituitary gland.

Treating acromegaly

At UPMC, the preferred surgical treatment for acromegaly is the Endoscopic Endonasal Approach (EEA) to remove the pituitary tumor. This innovative, minimally invasive technique uses the nose and nasal cavities as natural corridors to access hard-to-reach or previously inoperable tumors. Benefits of EEA include:

  • No incisions to heal
  • No disfigurement
  • Faster recovery time

Other acromegaly treatments available at UPMC include Gamma Knife® radiosurgery and medication.

Diagnosing Acromegaly

Symptoms of acromegaly usually develop over time, so the condition is not typically diagnosed for years. The average age for people to be diagnosed with acromegaly is around 40 or 45.

To make the diagnosis of acromegaly, your doctor will:

  • Ask you about your symptoms and medical history.
  • Perform a physical exam.
  • Order blood and imaging tests.

Acromegaly symptoms and complications

Symptoms of acromegaly may include:

  • Large growth in the hands and feet (rings or shoes may no longer fit)
  • Severe acne and thickening skin
  • Deepening voice
  • Protrusion of forehead and jaw
  • Excessive sweating
  • Fatigue

Complications of acromegaly may include:

  • Sleep apnea
  • Diabetes
  • High blood pressure
  • Heart disease
  • Irregular menstrual cycles (in women)
  • Erectile dysfunction (in men)

Lab and imaging tests for diagnosing acromegaly

Blood tests will measure the hormones produced by the pituitary gland, such as growth hormone (GH), insulin-like growth factor (IGF-I), and other pituitary hormones.

Your doctor might also order:

  • A glucose tolerance test to see if the level of growth hormone drops. This hormone will not drop in people with acromegaly.
  • An MRI or CT scan of your head to look for a tumor in your pituitary gland.

Acromegaly Treatments

If not treated, acromegaly can cause serious complications and may be fatal.

Goals of treatment include:

  • Removing or reducing the size of the pituitary tumor.
  • Reducing the production of growth hormone so that it is at a normal level.
  • Stopping and reversing the symptoms caused by the excess growth hormone.
  • Correcting other abnormalities to the thyroid, adrenal, and sex organs.

Depending on your symptoms, UPMC's neurosurgical team may recommend a combination of surgical and non-surgical approaches to treat acromegaly.

Minimally invasive surgery

For most cases of acromegaly, the best treatment is to remove the pituitary tumor (adenoma) that is causing the excessive growth hormone. The adenoma may be approached directly using the Endoscopic Endonasal Approach (EEA).This state-of-the-art, minimally invasive approach allows surgeons to access the tumor through the natural corridor of the nose, without making an open incision. Surgeons then remove the pituitary adenoma through the nose and nasal cavities.

The remaining pituitary gland is explored carefully to check for other lesions, and all abnormal tissue is removed.

EEA offers the benefits of no incisions to heal, no disfigurement, and a faster recovery time.

If you need complementary treatments, such as radiation, those therapies can begin soon after EEA surgery.

Gamma Knife® radiosurgery for acromegaly

Gamma Knife radiosurgery is a painless procedure that uses hundreds of highly focused radiation beams to target tumors and lesions within the brain, with no surgical incision.

For acromegaly, our neurosurgeons use the Gamma Knife for:

  • Residual tumor after surgery.
  • Elevated growth hormone levels, despite surgerytreatment, and medical management.

As the nation's leading provider of Gamma Knife procedures and treatment UPMC has treated more than 12,000 patients with tumors, vascular malformations, pain, and other functional problems.

Medicine for managing acromegaly

You may receive medications to:

  • Reduce the level of growth hormone that the pituitary gland produces.
  • Manage your condition if surgery was not curative.

Gamma Knife Radiosurgery
Dr. L. Dade Lunsford discusses Gamma Knife Radiosurgery.

Endoscopic Endonasal Approach (EEA)
Pituitary Tumor Removal Using the Endoscopic Endonasal Approach (EEA) at UPMC