Investigation included chest and abdominal ct scans

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Mr. Don Majic Juan, a 30-year-old Filipino presented to your clinic with an 11-year history of coarse facial features and progressive enlargement of hands and feet. Initial work-up revealed elevated insulin-like growth factor-1 and non-suppressible growth hormone level after 75 g glucose challenge test. Initial cranial MRI performed in the year 2010 showed the absence of pituitary adenoma. The patient was lost to follow-up. He again consulted in the year 2011 and a repeat cranial MRI and a dedicated pituitary MRI were performed and both did not reveal any pituitary mass. Further investigation included chest and abdominal CT scans, both of which did not show any neoplasm. What would the Dx be and the course of Tx?

Reference no: EM132408264

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