Some patients will have residual acromegaly despite undergoing a successful transsphenoidal surgical procedure by experienced neurosurgeons. Fortunately, there are a number of pharmacologic agents that have demonstrated effi cacy in the management of patients with residual and recurrent acromegaly and in those who are not candidates for primary surgery. Some of these drugs have changed the natural history of treated acromegaly. As a result, many of the more severely distressing end-stage manifestations of the disorder are now seen only infrequently.
There is extensive medical literature regarding the psychological manifestations of both functional and endocrine inactive pituitary tumors. Patients may experience any one of a multitude of personality and psychiatric disorders as a consequence of perturbations in homeostasis due to either excess or deficient secretion of one or more anterior pituitary hormones.