A female patient with a history of bronchial asthma, arterial hypertension, septal myocardial hypertrophy, obesity and long standing hypothyroidism.
At the age of 74, under medical supervision, acromegaloid facies, wide hands with large fingers and large feet were investigated.
Basal GH was requested, which was high: 2.8 and 1.6 ng/ml.
Subsequently, a post-load measurement of 75 g glucoseml was performed on mna 60 min, a value of GH that did not suppress: 2.3 ng/ prolactin with 166 mg/dl 2dl hormone receptor: TSH/T4 levels normal.
A turcica computed tomography (CT) was requested, which showed a 10 mm adenoma lateralized to the left and deviation of the stem to the right.
The patient refused surgical treatment.
Three years later, a new CT scan of the turcica showed an adenoma of 7 mm that deformed the sellar diaphragm and caused a mild peeling of the vestibule, without signs of intratumoral hemorrhage.
At that time, IGF-1 (insulin-simile growth factor 1) was in a low normal range for age: 64.1 ng/mL-188 ng/mL).
At seven years of follow-up, a new GH measurement was performed after glucose load, at 60 min a value of 1 ng/ml was observed with blood glucose of 174 mg/dl. At nine years, the presence of adenoma was reassess
