From Subtle Signs to Severe Sequelae-A Century of Symptomatology and Comorbidities in the Diagnosis of GH-Secreting Pituitary Neuroendocrine Tumors: A Systematic Review.

Abstract

<b>Background/Objectives</b>: Somatotropinomas rank as the second most prevalent functional pituitary neuroendocrine tumors (PitNETs), responsible for acromegaly in adults and gigantism in children. Early diagnosis and treatment would help prevent irreversible physical changes and other associated comorbidities. The aim of this review is to characterize the symptomatic presentation of growth hormone (GH)-secreting PitNET at the time of diagnosis. <b>Methods</b>: A search was conducted in PubMed, Scopus, Cochrane, and the Virtual Health Library (VHL). Primary descriptive and analytical studies were selected if they were written in Spanish or English and addressed the symptoms of acromegaly and/or gigantism due to somatotropinomas. <b>Results</b>: Out of 8470 articles, 93 fulfilled the inclusion criteria, covering 1745 patients (55.4% women). The most frequent diagnostic signs/symptoms were enlarged extremities (12.4%) and facial changes (13.1%). Endocrine-metabolic (42.82%) and cardiovascular (31.45%) were the most prevalent comorbidities. The average diagnostic delay was 6.7 years, with the number of reports of the disease significantly increasing in recent decades, most likely due to ongoing advances in imaging and standardized hormonal tests. <b>Conclusions</b>: Timely recognition of a somatotropinoma's symptoms and comorbidities is crucial for early diagnosis and referral to specialized care and the prevention of permanent physical and/or physiological changes.