What is first-line therapy for acromegaly?
Transsphenoidal surgical excision of the pituitary adenoma is usually first-line therapy in acromegaly. The procedure is associated with normalization of GH levels in approximately 90% of patients with well-defined microadenomas.8-11 Surgical remission rates are lower in patients with macroadenomas because of the large, fibrous, and frequently invasive nature of these tumours, which makes complete resection unlikely.8,11 Unfortunately, macroadenomas constitute the majority of tumours detected in patients with acromegaly on initial presentation.