​Pituitary Gigantism

The pituitary gland is a small pea-sized gland located at the base of the brain, which is responsible for controlling growth and development and the functioning of the other hormone-producing glands. In pituitary gigantism, there is excessive secretion of growth hormone before the child reaches adolescence due to over activity of the pituitary gland. As a result, your child’s height will end up growing abnormally as compared to other children of comparable age and gender.

The most common cause of gigantism is an adenoma, which is a non-cancerous tumour of the pituitary gland. The tumour can cause excessive secretion of growth hormone by the pituitary gland. Other, less common causes of pituitary gigantism include disorders called carney complex, multiple endocrine neoplasia type 1 and Neurofibromatosis Type 1, which cause tumours in tissues, endocrine glands and the nervous system, respectively. Another disease called the McCune-Albright syndrome, in which there is abnormal growth of bone tissue may also be responsible for pituitary gigantism. 

Gigantism is a childhood condition that causes excessive growth in height, and also in girth, before the child’s growth plates fuse and harden.

Abnormal growth in height is the most common symptom associated with pituitary gigantism. Though height growth is the most noticeable sign, girth is also affected. The condition can be difficult for parents to identify initially, as the growth in height may be confused with normal growth spurts. Over time, your child will start looking much larger than his/ her peers.

Other accompanying signs and symptoms include:

  • Very large hands and feet with thick toes and fingers

  • Hands that feel like soft bread dough

  • Prominent jaw and forehead

  • Flat nose and large head, lips, or tongue

  • Delayed puberty

  • Gaps between teeth

  • Thickening of facial features

  • Headaches and weakness

  • Problems sleeping

  • Skin changes, such as increased skin tags, more sweating and oily skin

  • Arthritis

  • Increased tissue in wrists can cause nerves to compress, a condition known as carpal tunnel syndrome

The severity of these symptoms will depend on the size of tumour in your child’s pituitary gland.                         ​

Children suffering from gigantism are also at a greater risk for developing other tumours of the body and should be frequently assessed by a Paediatric Endocrinologist. Early diagnosis and treatment is essential for your child’s paediatrician to be able to start the treatment to prevent your child from growing larger than normal. 

Therefore, regular visits to your child’s Paediatric Endocrinologist working with the Children’s Hospital of The Aga Khan University Hospital in the initial months of his/ her life are important for the paediatrician to identify any abnormal growth in height and weight. If you suspect that your child’s growth is much more than those of his/ her peers, immediate medical attention must be sought so that early diagnosis and treatment can be started if required.                         ​

Your time with your doctor may be limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.                         

The doctor will evaluate your child’s rate of growth in the early years, which will help reach an initial diagnosis. If pituitary gigantism is suspected, the doctor will request the following diagnostic tests:

  • Tests for measuring the levels of growth hormones and insulin-like growth factor 1 (IGF-1), which is another important hormone responsible for growth.

  • A glucose tolerance test may also be requested, whereby your child’s blood glucose levels after consuming a glucose drink will be evaluated. If there is no drop in growth hormone levels after consumption, it could indicate pituitary gigantism in your child.

  • Blood tests may also be requested to check the levels of other hormone, such as the thyroid hormone, testosterone in boys and estradiol in girls or prolactin, which is a hormone released by the pituitary gland.

  • Imaging tests such as the MRI and CT scan may also be requested to look closely at the tumour and check its size and position.​

Two factors will influence the treatment option that will be suggested for your child:

  • Size and location of the pituitary tumour

  • Age of your child

Surgically removing the tumour is the preferred treatment option which offers the best chance for cure. You may be referred to a neurosurgeon working with the Mind and Brain Service Line at The Aga Khan University Hospital for this surgery. Our neurosurgeons practice the latest surgical techniques, allowing pituitary tumours to be removed that were previously considered unable to be removed surgically.

Yet in some cases surgery may not be an option because of the location of the tumour near a critical blood vessel or nerve, posing a very high risk. In that case, medication to help shrink the tumour or stop production of excess growth hormones may be recommended. These may be administered orally or via injection.

If the above options are not effective, your child’s doctor may consider radiation therapy which uses focused radiation beams to eradicate the tumour.

Talk to your child’s doctor working with the Children’s Hospital Service Line of The Aga Khan University Hospital and other healthcare professionals you may have been referred to in detail about your child’s condition and the associated risks and possible complications of any treatment option.                         ​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.                         ​

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.                         

​​The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.