x
x
x
x
x
x
x
x
x
x
x
x
Acromegaly: management first line ?
rans-sphenoidal surgery
if inoperable trans-sphenoidal surgery
directly inhibits the release of growth hormone
for example octreotide
GH receptor antagonist that can be given third line
pegvisomant- GH receptor antagonist
following failed surgical/medical treatment
External irradiation