Acromegaly
Acromegaly is a chronic endocrine disorder caused by excessive growth hormone (GH) secretion, most commonly from a benign pituitary adenoma. The excess GH stimulates hepatic insulin-like growth factor 1 (IGF-1) production, driving progressive skeletal overgrowth, soft tissue enlargement, and multisystem organ changes that significantly increase morbidity and mortality when untreated.
Understanding Acromegaly
Acromegaly develops insidiously over years, with patients typically presenting five to ten years after onset. The slow progression means that many early signs — such as enlarging hands and feet, coarsening facial features, and excessive sweating — are frequently dismissed as normal aging. The underlying pituitary adenoma, while benign, compresses surrounding structures within the sella turcica and cavernous sinus, potentially causing visual field deficits from optic chiasm compression and hypopituitarism from normal pituitary tissue displacement.
Left untreated, acromegaly reduces life expectancy by an average of ten years, primarily due to cardiovascular disease, diabetes, and increased colorectal cancer risk. Surgical resection of the adenoma via transsphenoidal craniotomy offers the best chance of biochemical remission. For international patients, Istanbul provides access to elite pituitary surgeons at a fraction of Western costs, with waiting times in days rather than months.
Treatment Options for Acromegaly
View All ProceduresPituitary Tumour Treatment in Turkey
The pituitary gland (a pea-sized organ at the base of the brain) is the body's master hormonal regulator, controlling thyroid function, growth, cortisol production, reproductive hormones, and more. Pituitary tumours (adenomas) are almost always benign, but they can cause significant problems through two mechanisms: hormonal overproduction (secreting excess growth hormone, cortisol, or prolactin) and mass effect (compressing the optic nerves, causing visual field loss, or pressing on the brain).
arrow_forwardCraniotomy (Brain Surgery) in Turkey
A craniotomy is the surgical opening of the skull to access the brain for the removal of tumours, clipping of aneurysms, resection of arteriovenous malformations (AVMs), or decompression of swollen brain tissue. A bone flap is temporarily removed, the intracranial procedure is performed under microscope guidance, and the bone is secured back in place at closure. It remains the definitive approach for lesions that cannot be treated with less invasive methods such as Gamma Knife radiosurgery.
arrow_forwardSymptoms of Acromegaly
The clinical features of acromegaly are driven by both GH excess and the local mass effect of the pituitary adenoma. Acral enlargement causes increasing shoe and glove size, prognathism (protruding jaw), macroglossia (enlarged tongue), and frontal bossing. Soft tissue swelling produces coarse facial features, a thickened nasal bridge, and enlarged lips. Systemic effects include hypertension in 40 per cent of patients, diabetes mellitus or impaired glucose tolerance in 50 per cent, obstructive sleep apnoea in 70 per cent, osteoarthritis, and carpal tunnel syndrome. Headaches and visual field defects — particularly bitemporal hemianopia — indicate chiasmal compression from a large adenoma.
Diagnostic Pathways
IGF-1 measurement is the recommended first-line screening test; an elevated age-adjusted IGF-1 level is highly suggestive of acromegaly. Oral glucose tolerance test (OGTT) confirms the diagnosis — failure of GH to suppress below 1 ng/mL after a 75 g glucose load is diagnostic. Pituitary MRI with gadolinium localises the adenoma and defines its size, extension, and relationship to the optic chiasm and cavernous sinuses, which determines the surgical approach. Formal visual field testing is performed in all patients with suprasellar extension of the adenoma.
Advanced Treatment Options at Vellum Select
Vellum Select offers comprehensive acromegaly management through Prof. Dr. Türker Kılıç, an experienced pituitary neurosurgeon performing both microscopic and endoscopic transsphenoidal approaches.
Transsphenoidal Adenomectomy
For the majority of pituitary adenomas causing acromegaly, Pituitary Tumour Treatment in Turkey via transsphenoidal surgery is the first-line treatment. This approach accesses the pituitary gland through the nasal cavity and sphenoid sinus — no external incision, no visible scar, and typically a 24–48 hour hospital stay. Biochemical remission rates for microadenomas (under 1 cm) exceed 85 per cent in expert hands. For larger or invasive adenomas, or when surgery is contraindicated, adjunctive medical therapy or radiation may be required.
Craniotomy for Giant Adenomas
For large pituitary adenomas with significant suprasellar or parasellar extension not amenable to transsphenoidal resection, Craniotomy (Brain Surgery) in Turkey via a subfrontal or pterional approach provides the exposure necessary for safe tumour removal.
To discuss your acromegaly diagnosis with Prof. Dr. Türker Kılıç, view his profile or contact Vellum Select to arrange a consultation.