Acromegaly, a somatic growth and proportion disorder first described by Marie in 1886,<sup>68 Marie P. On two cases of acromegaly: Marked hypertrophy of the upper and lower limbs and the head Rev Med 1886 ;  6 : 297-333

Cliccare qui per andare alla sezione Riferimenti</sup> occurs with an annual incidence of approximately 1000 patients. Elevated levels of growth hormone and insulin-like growth factor 1 (IGF-1) are the hallmarks of this syndrome<sup>73 Melmed S., Braunstein G.D., Horvath E. , e al. Pathophysiology of acromegaly Endocr Rev 1983 ;  4 : 271-290  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> and are usually caused by growth hormone–secreting pituitary tumors or, rarely, extrapituitary disorders.<sup>71 Melmed S. Acromegaly N Engl J Med 1990 ;  322 : 966-977  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> Clinical manifestations of acromegaly include skeletal and soft-tissue growth and deformations, and cardiac, respiratory, neuromuscular, endocrine, and metabolic complications. The increased morbidity associated with elevated growth hormone levels requires early and aggressive control of the disease. Although surgery is considered the treatment of choice, complete macroadenoma resection, especially if invasive, is difficult even for the skilled surgeon, and there is a low rate of biochemical control. Pharmacologic treatment has assumed more importance in managing these patients using long-acting somatostatin analogues, dopamine agonists, and growth hormone receptor antagonists. This article reviews recent advances in ethiology, clinical manifestations, diagnosis, and treatment of acromegaly.