Surgery is the first-line treatment option for pituitary growth hormone (GH) tumours, and minimally invasive transnasal pterygoid sinus surgery is less invasive, has fewer complications and a lower mortality rate than traditional open surgery, making it the most commonly used procedure today, with secondary surgery available if the patient can tolerate one unsuccessful operation and if there is an indication for surgery.
The rate of surgical remission is inversely related to preoperative GH and insulin-like growth factor-1 (IGF-1) levels, as well as to tumour size and the presence of peripheral tissue invasion.
Severe systemic limb enlargement manifestations (including airway hypertrophy obstructing anesthetic intubation, severe cardiomyopathy, and cardiopulmonary dysfunction) may be improved preoperatively with growth inhibitor analogs.