Acromegaly Surgery

Surgery to Remove a Pituitary Tumor

Written by Daniel J. Toft MD, PhD

Surgery is usually the first treatment offered to patients with acromegaly. By removing the pituitary tumor (also called a pituitary adenoma) that's making too much growth hormone (GH), the symptoms of acromegaly should subside and GH levels should return to normal.

The best candidates for surgery are patients who have:

Goals of Pituitary Tumor Surgery to Treat Acromegaly
Removing the pituitary tumor that's secreting too much GH should alleviate the effects and symptoms of acromegaly because your body should then be producing a normal amount of GH. Getting GH and insulin-like growth factor-1 (IGF-1) back into acceptable ranges is the number one goal of surgery.

Other important goals of surgery to treat acromegaly include:

How Acromegaly Surgery Is Performed
To remove a pituitary tumor, a surgeon typically goes through the nose or the upper lip. Reaching through an incision and using tools specific to pituitary surgery, the surgeon will remove the tumor. The type of surgery is called transsphenoidal. The sphenoid sinus is behind the nose, and surgeons can reach this space either through the nose (transnasal) or through the upper lip (translabial).

Throughout the surgery, the surgeon will be able to see by using an endoscope, a tool with a camera on the end. It will be inserted through the incision.

The surgeon will also use magnetic resonance imaging (MRI). With intraoperative MRI, he or she will be able to quickly and easily check progress and determine if the whole tumor has been removed.

Possible Surgical Complications
As with any surgery, removing a pituitary tumor involves possible complications. Because there are many important structures in the brain, the surgeon will be incredibly careful while operating, but there may still be complications. Your surgeon will explain all of the risks of surgery beforehand. Some of the risks include:

Important Acromegaly Surgery Note
It's important to maintain realistic expectations when going into surgery for acromegaly. Your surgeon will explain what you can expect from the surgery and what the goals are. It is possible, even after surgery, that your GH levels won't be normal and that you may still have some symptoms of acromegaly.

Talk through the entire procedure with your surgeon. Ask any questions that you have so that you understand what will happen before, during, and after the surgery to remove the pituitary tumor that's causing your acromegaly symptoms.

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