Multimodality treatment of pituitary adenomas.

Acromegaly is caused by excessive secretion of growth hormone (GH). The average annual incidence of acromegaly is approximately 3.3 per million, and the prevalence is approximately 60 per million (50). GH-secreting adenomas account for 20% of functional adenomas, and 75% of GH adenomas are macroadenomas (50). The mortality in untreated acromegaly is two to three times higher than that of the general population, but with appropriate reduction of GH hypersecretion, it normalizes (50). Treatment is aimed at normalizing GH secretion, eradicating the tumor, preserving normal pituitary function, and managing associated complications. The treatments include transsphenoidal surgery or craniotomy, pharmacotherapy, radiation, or combination therapy.