Gigantism Symptoms, Causes, and Treatment

Gigantism is a rare condition in which the body produces excessive growth hormone, causing abnormal and often uncontrollable physical growth, especially during childhood or adolescence. One of the most well-known cases is Tanya Angus, whose life was marked by constant growth due to acromegaly, a related disorder that began affecting her in her teens. At her tallest, she stood more than seven feet and weighed nearly 400 pounds.

Stories like hers highlight the physical and emotional challenges caused by gigantism. The disorder not only affects stature but also puts enormous strain on the body and the individual's day-to-day life. Understanding what causes such excessive growth, and how people cope with it, reveals much about human health and the complexities of rare diseases.

What Is Gigantism?

Gigantism is a rare medical disorder that leads to excessive growth and unusual height in children and adolescents. This abnormal growth results from specific hormonal imbalances, and it differs in important ways from related conditions affecting adults.

Definition and Overview

Gigantism is a condition caused by the overproduction of growth hormone, or somatotropin, during childhood or adolescence, when the growth plates in bones are still open. The most common cause is a benign tumor on the pituitary gland called an adenoma.

Key signs of gigantism include:

Excessive height for age and sex
Rapid growth in limbs and face
Accelerated bone and tissue development

Diagnosis is typically confirmed through hormone tests and imaging studies. Without timely treatment, the excess growth hormone continues to drive abnormal body changes. If managed early, some symptoms and growth can be controlled, but untreated cases lead to severe physical complications and health risks.

How Gigantism Differs from Acromegaly

Gigantism and acromegaly both involve excessive secretion of growth hormone, but the timing makes a critical difference. Gigantism begins before the growth plates close, resulting in significant increases in height and overall size.

Acromegaly, on the other hand, occurs in adults after growth plates have fused. This means that, while bones don't lengthen, there is abnormal growth of hands, feet, jaw, and other soft tissues. The main distinctions can be summarized:

Condition Onset Main Symptoms Gigantism Before puberty Abnormal height, rapid growth Acromegaly After puberty Enlarged hands/feet, facial bones

Both conditions are linked to pituitary adenomas but present different health challenges and require tailored treatments.

Understanding Rare Disorders

Gigantism is categorized as a rare disorder because it affects an extremely small percentage of the population. Because of its rarity, diagnosis may be delayed or misidentified, which emphasizes the need for greater clinical awareness.

People living with rare disorders like gigantism often encounter additional medical problems. High levels of growth hormone can affect metabolism, the heart, and other organs, increasing the risk for complications. Social and psychological impacts, such as isolation or difficulty with daily activities, are also common.

Early intervention and supportive care are essential to manage symptoms and improve quality of life. Clinical research continues to seek better diagnostic and therapeutic options for rare conditions like gigantism.

Causes of Gigantism

Gigantism results from changes in hormonal regulation, particularly excess growth hormone, and malfunctioning of the pituitary gland. Noncancerous tumours within the pituitary gland are a frequent trigger for this rare condition.

Role of Growth Hormone

Growth hormone (GH) is essential for normal growth and development in children. When the body produces too much GH during childhood or adolescence, it leads to abnormal and excessive growth of bones and tissues. This overproduction drives the striking height and size seen in individuals with gigantism.

The excess hormone can also cause rapid growth of internal organs and soft tissue. Symptoms such as enlarged hands, feet, and facial features may develop gradually. Table 1 below shows effects of normal vs. excess growth hormone:

Normal GH Levels Excess GH Levels Height Age-appropriate Excessive for age/gender Bone growth Regulated Rapid and uncontrolled Organ size Normal May increase (organomegaly)

Impact of the Pituitary Gland

The pituitary gland is a small endocrine organ located at the base of the brain. It acts as the master regulator for much of the body’s hormone production. Its role is especially important in regulating the release of growth hormone.

When the pituitary gland malfunctions or is structurally affected, it may release growth hormone in inappropriate amounts. In cases of gigantism, this dysregulation usually happens during childhood, before the growth plates in bones have closed. Early onset is why children with gigantism experience abnormal height and body proportions compared to their peers.

Pituitary Tumour and Benign Tumour

A benign tumour, usually an adenoma, is the most common underlying cause of gigantism. These tumours form within the pituitary gland and stimulate it to secrete too much growth hormone. Despite being noncancerous, these tumours exert significant effects by physically enlarging the gland and disturbing its hormone secretion.

A pituitary tumour may not cause pain but can lead to symptoms linked with excess hormone production. Sometimes the tumour can affect nearby brain structures, causing headaches or vision problems. Early detection and treatment are crucial to control hormone levels and limit abnormal growth.

Symptoms and Signs of Excessive Growth

Children with gigantism experience both visible physical changes and measureable hormonal abnormalities. These effects often develop slowly, making the early diagnosis a challenge for families and clinicians.

Physical Changes in Gigantism

Excessive linear growth is the hallmark sign. Affected children rapidly outgrow peers in height, with noticeable increases over months or years. Their limbs, hands, and feet may enlarge disproportionately compared to the rest of their bodies.

Other distinct features can include broadening of the nose, thickening of the lips, and prominent forehead (frontal bossing). Facial features can become more coarse. Some individuals also experience enlargement of internal organs such as the heart, liver, or kidneys.

Common symptoms in daily life may include difficulty finding properly fitting clothes and shoes, joint pain, and increased fatigue. Table 1 offers a summary of several common physical changes:

Symptom Example Observed Tall stature Height far above age average Enlarged hands/feet Larger shoe and glove size Facial changes Broad nose, thickened lips Organ enlargement Detected by medical imaging

Growth Hormone Levels

Gigantism is directly caused by excessively high levels of growth hormone (GH) during childhood and adolescence. This abnormal hormone elevation leads to increased production of insulin-like growth factor 1 (IGF-1).

Testing for these hormone levels is essential for diagnosis. Most children with gigantism have GH levels above the normal reference range for their age. Elevated IGF-1 is also a consistent finding.

Laboratory measurements can help distinguish excessive growth from standard puberty variations. Persistent GH elevation usually means further investigation is required to identify a possible pituitary gland tumor, often the underlying cause.

In some cases, symptoms like excessive sweating, insomnia, or headaches may be linked to abnormal hormone activity. These additional symptoms can provide important diagnostic clues.

Health Problems and Complications

Gigantism leads to serious health issues that affect daily life and can also shorten lifespan if not managed. These complications include both everyday challenges and significant medical risks.

Quality of Life Impacts

Children and adolescents with gigantism often endure joint pain, muscle weakness, and fatigue due to excess growth hormone. These symptoms can make it difficult to participate in normal activities.

Mobility issues are common. Simple tasks like walking, standing up, or climbing stairs require more effort, and accessing properly sized clothing, shoes, or furniture can be a daily challenge.

Social and emotional difficulties are also frequent. People may experience bullying, unwanted attention, and isolation due to height and appearance differences.

Frequent headaches, vision problems, and sleep disturbances are reported. These are usually the result of an enlarged pituitary gland pressing against nearby brain structures.

Daily life often involves ongoing medical care. Growth must be carefully monitored and treatments, such as medication or surgery, may be needed to control hormone levels and prevent complications.

Life-Threatening Risks

Gigantism increases the risk for several serious health issues, including heart disease, high blood pressure, and type 2 diabetes. The heart is particularly affected because it must work harder to pump blood throughout a larger body.

Respiratory problems are possible, especially if the chest cavity or tongue grows excessively and interferes with breathing during sleep. Sleep apnea is common and can lead to fatigue and stressed organs.

Joint deterioration and arthritis can become severe, resulting in long-term mobility loss. Early intervention is necessary to preserve joint function.

If untreated, gigantism can decrease life expectancy. Tumors that cause excess growth hormone may also press on the brain and nerves, requiring prompt surgical intervention.

Without medical management, multi-organ complications like kidney, liver, or heart failure may develop, increasing the risk of sudden, life-threatening events.

Diagnosing Gigantism

Early recognition and accurate diagnosis of gigantism are essential to prevent long-term complications. Advances in both clinical assessment and laboratory testing have greatly improved the chances of identifying gigantism at a treatable stage.

Medical Assessment

Gigantism is typically suspected when a child or adolescent shows excessive growth compared to peers. Doctors first take a detailed growth history, focusing on rapid increases in height and changes in facial or hand size.

A physical exam will assess for signs such as enlarged hands, feet, and facial features. These findings may point to elevated growth hormone (GH) activity.

Blood tests are crucial. They measure levels of growth hormone and insulin-like growth factor 1 (IGF-1). Elevated values suggest abnormal GH production.
The oral glucose tolerance test (OGTT) is often used. When glucose is consumed, GH should normally fall. In gigantism, GH levels remain high.

Imaging, such as MRI scans of the pituitary gland, helps identify if a benign tumor is causing hormone overproduction.

Early Treatment Approaches

Early intervention can reduce or prevent complications of gigantism and may halt abnormal growth. First-line treatment often targets the source of excess growth hormone, usually a pituitary tumor.

Surgery is the most common initial therapy if a tumor is found. Transsphenoidal surgery allows removal of the tumor through the nasal passages with minimal external scarring.

If surgery cannot fully correct hormone levels, medications such as somatostatin analogs or GH receptor blockers may be prescribed. These drugs work by lowering growth hormone production or blocking its effects.

Radiation therapy may be considered if other treatments are not successful. Early diagnosis and prompt treatment increase the likelihood of normalizing growth and hormone levels, helping to avoid irreversible changes.

Available Treatment Options

Gigantism is often caused by excess growth hormone production, usually due to a benign tumor on the pituitary gland. Treatment focuses on reducing hormone levels and addressing underlying causes to prevent further abnormal growth.

Surgery for Pituitary Tumour

Surgical removal of a pituitary tumor is the primary option for many patients, especially when a tumor is clearly visible on imaging scans. The most common procedure is transsphenoidal surgery, where surgeons access the tumor through the nasal cavity, minimizing damage to surrounding tissue.

This approach aims to remove as much of the tumor as possible, which can quickly reduce growth hormone levels. Surgical success depends on the size and location of the tumor. In some cases, complete removal is not possible, and additional treatments may be necessary.

Risks — such as infection, bleeding, or pituitary hormone imbalance — are generally low when performed by experienced medical teams. Surgery can offer significant benefits, especially when combined with other therapies.

Medication Management

When surgery cannot fully remove the tumor, or if hormone levels remain high, medication is often used to regulate growth hormone production. The main drug classes include:

Somatostatin analogs (like octreotide or lanreotide): These drugs decrease the release of growth hormone from the pituitary.
Dopamine agonists (such as cabergoline): They can help suppress hormone secretion in some cases.
Growth hormone receptor antagonists (like pegvisomant): These agents block the effects of growth hormone on tissues.

Medication is usually given as injections or tablets. Regular blood tests are necessary to measure hormone levels and monitor the effectiveness of treatment. Adjustments to dosing or drug type may be needed over time, depending on the patient’s response. Medication can be lifelong if surgical cure is not achieved.

Living with Gigantism

Daily life for someone with gigantism often involves unique physical and medical challenges. The disorder can affect the ability to move independently and requires extra attention to serious health issues like blood sugar control.

Mobility Challenges and Wheelchair Use

Individuals with gigantism may experience significant joint pain and muscle weakness. As a result, walking or standing for extended periods can be difficult. For some, the stress on bones and joints leads to frequent fractures or arthritis at a younger age.

A wheelchair often becomes necessary to maintain mobility and independence. Using a wheelchair can help reduce the strain on the body and lower the risk of falls. Proper wheelchair fitting is important for those with above-average height, as standard models may not provide sufficient support.

Environmental obstacles, such as narrow doorways and inaccessible transport, can make daily activities challenging. Custom solutions and physical therapy are sometimes required to adapt to these issues.

Managing Diabetes

People with gigantism have an increased risk of diabetes due to the effects of excess growth hormone on insulin resistance. Frequent monitoring of blood glucose levels is crucial. Symptoms can be more severe if not managed properly.

Treatment typically includes medication to regulate insulin and a diet tailored to manage blood sugar. Regular medical check-ups help to watch for complications, such as nerve or kidney damage. Managing diabetes effectively is essential for maintaining quality of life, especially alongside other issues associated with being a giant.

The Story of Tanya Angus

Tanya Angus, a woman from Las Vegas, was one of the most well-known modern cases of gigantism. Her life and struggles highlighted the challenges caused by pituitary tumors and the impact of this rare disorder.

Life in Las Vegas and Public Awareness

Tanya Angus was born and raised in Las Vegas, Nevada. Her rapid and uncontrolled growth began in her teenage years, later traced to a tumor on her pituitary gland. This tumor caused her body to produce excessive growth hormone, leading to severe gigantism.

Angus’s height and physical changes quickly surpassed her peers. By adulthood, she stood over 6 feet tall and weighed nearly 400 pounds, with persistent symptoms affecting her mobility and health. Multiple surgeries and radiation treatments failed to stop her growth or cure her condition.

Her case gained national attention, bringing needed awareness to gigantism and acromegaly. Tanya spoke publicly and advocated for research, shedding light on daily life with such a challenging disorder. She passed away at age 34, becoming a symbol for others dealing with rare endocrine diseases.

The Girl Who Couldn’t Stop Growing