Acromegaly

People within USA:

• Prevalence is 40 cases/million; incidence is 3 to 8 new cases/million/y.

• Occurs with equal frequency in men and women and most frequently diagnosed in third to fifth decades of life (5 to 20 y lag between onset of symptoms and diagnosis).

Common conditions increasing periop risk include airway abnormalities, CV dysfunction (Htn), resp impairment (obstructive sleep apnea), endo abnormalities (hyperglycemia).

Difficulty or inability to ventilate and/or intubate

Extent of CV disease

Postop airway obstruction

Acromegaly is a slowly progressive, debilitating endocrinopathy resulting from excess secretion of growth hormone, usually from a benign macroadenoma of the anterior pituitary gland, and characterized by overgrowth of soft tissues and bone and cartilage of skeleton (nose, jaw, hands, fingers, feet, toes). Excess growth hormone before puberty (epiphyseal closure) leads to gigantism (<5% of acromegalics).

Greater than 99% of cases result from primary pituitary adenoma.