Gigantism is a rare condition that results from excessive growth hormone (GH) production in childhood or adolescence, before the growth plates have closed. This excess GH leads to abnormally rapid growth and increased height.

Symptoms

  • Excessive Height and Growth: Children grow in height and size much beyond their peers.

  • Large Hands and Feet: Disproportionately large compared to the rest of the body.

  • Facial Features: Enlarged facial features, including the nose, lips, and tongue.

  • Joint Pain: Often due to rapid and excessive growth.

  • Delayed Puberty: Puberty may be delayed or incomplete.

  • Headaches and Vision Problems: Caused by the pressure of a pituitary tumor on nearby optic nerves.

  • Sleep Apnea: Due to enlarged tissues in the throat.

Causes

  • Pituitary Tumors: The most common cause is a noncancerous tumor (adenoma) of the pituitary gland, which produces excess GH.

  • Genetic Conditions: Rare genetic conditions, such as McCune-Albright syndrome or Carney complex, can increase the risk of developing gigantism.

Treatment

The treatment for gigantism focuses on reducing GH levels to normal and addressing the effects of the tumor on the pituitary and surrounding structures.

  1. Surgery: Surgical removal of the pituitary tumor is often the first line of treatment.

  2. Medication:
    • Somatostatin Analogs (e.g., Octreotide, Lanreotide): These drugs reduce GH production.

    • Growth Hormone Antagonists (e.g., Pegvisomant): Blocks the effects of GH.

    • Dopamine Agonists (e.g., Bromocriptine, Cabergoline): May be used to shrink the tumor in some cases.

  3. Radiation Therapy: Used if surgery isn't completely successful or as an additional treatment option.

Medication

  • Octreotide and Lanreotide: To reduce GH production.

  • Pegvisomant: To block the effects of GH.

  • Bromocriptine and Cabergoline: Sometimes used to shrink pituitary tumors.

Post-treatment, regular monitoring is essential to ensure that hormone levels remain in the normal range and to monitor for tumor recurrence. It's also important to address any complications of gigantism, such as joint pain or cardiovascular issues. Early detection and treatment are key to preventing or minimizing the long-term effects of gigantism.