Snapshot A 52 year-old man complains of increased hat size and headaches when he wakes up in the morning. Physical exam reveals mild diastolic hypertension, prominant jaw with spaces between the teeth, large hands and feet, and generalized muscle weakness. Introduction Benign pituitary adenoma that releases excess growth hormone login to view 1 more bullet Gigantism if the condition occurs before the fusion of the epiphysis Acromegaly if it occurs after skeletal epiphyseal closure Presentation Symptoms login to view 9 more bullets Physical exam login to view 2 more bullets Evaluation Photographic changes login to view 1 more bullet Serology login to view 4 more bullets Suppression tests login to view 1 more bullet MRI/CT login to view 1 more bullet Cardiomegaly on CXR login to view 1 more bullet Treatment Surgical login to view 1 more bullet Medical login to view 6 more bullets Prognosis, Prevention, and Complications Cardiomegaly progressing to CHF is the most common cause of death