GIGANTISM

excessive growth in stature, well beyond the average for the individual's race and environmental conditions. In many cases tall stature results from hereditary, dietary, or other factors. In other cases, gigantism is caused by disease or disorder in those parts of the endocrine system that regulate growth and development. Androgen deficiency, for example, delays the closure of end plates, or epiphyses, of the long bones, which usually takes place when full growth is achieved. If the pituitary gland functions normally, producing appropriate amounts of growth hormone, while epiphyseal closure is delayed, the growth period of the bones will be prolonged. Gigantism associated with androgen deficiency is more frequent in men than in women and may be genetic. Another type of gigantism associated with endocrine disorder is pituitary gigantism, caused by hypersecretion of the growth hormone somatotropin, during childhood or adolescence, prior to epiphyseal closure. Pituitary gigantism is usually associated with a tumour of the pituitary gland. Acromegaly (q.v.), a condition marked by progressive enlargement of skeletal extremities, occurs if growth hormone continues to be produced in large volume after epiphyseal closure. (Signs of acromegaly are occasionally seen in younger patients, prior to closure.) Since most pituitary giants continue to produce somatotropin after they reach adulthood, the two conditionsgigantism and acromegalyare often concurrent. In pituitary gigantism, growth is gradual but continuous and consistent; the affected person, with bones in normal proportion, may attain a height of eight feet. Muscles may be well developed but later undergo some atrophy or weakening. The life span of pituitary giants is shorter than normal because of their greater susceptibility to infection, injury, and metabolic disorders. Treatment by surgery or irradiation of the pituitary gland curtails further growth, but stature cannot be reduced once gigantism has occurred.