Recent developments in the treatment of acromegaly.

In acromegaly the microsurgical transsphenoidal removal of the pituitary adenoma has become the most widely used method of treatment. In experienced hands, the therapeutic goal of rapid normalization of hormone excess and preservation of pituitary function can be achieved in most of the patients if the tumours are not too large. Medical treatment or radiotherapy alone, or in combination, are less successful for primary treatment. They are indispensable as alternative therapy in those patients not suitable for operation, and as additional methods after incomplete tumour removal. Large invasive adenomas still present a challenge for further improvement of therapeutic facilities. Intraoperative GH-measurements, as recently introduced by us, help to identify tumour residues and justify additional surgical exploration at higher risk.