Endocrine Abstracts

The aim: To study case of partial gigantism.

Methods: To evaluate the patient’s condition we conducted hormonal and biochemical investigations, as well as total blood and clinical urine analysis; Doppler sonography and multislice computed tomography were performed.

Results: STH – 25.8 mIU/l (normal range: 2.0–20 mIU/l); IGF – 2.9 mg/l (normal range for the age: 13–100 mg/l); ALPase – 160 U/l (normal range: up to 644 U/l); total calcium – 2.08 mmol/l (normal range: 2.5–3.0 mmol/l); phosphorous – 1.42 mmol/l (normal range: 1.3–2.26 mmol/l). Doppler sonographyof left extremity demonstratedpresence of hyperechoic(circular) layer in the projections of the first and second left toes.

Multislice computed tomography (MSCT) of left extremitydemonstrated enlargement of the first and second left toes with the metatarsal involvement. The soft tissues of the area contain multiple poorly demarcated thin-wall cyst-like formations with cystic content density of -120+34 HU. Cortical layers of adjacent toe or metatarsal bones demonstrated no disruptions of continuity. Spacing intervals between the first and second toes and metatarsal bones are enlarged. Middle phalanx of the second toe is laterally displaced. Boundaries of bones are well defined; no disruptions of cortical layer or periosteal reaction can be seen. The soft tissues of right extremity have no changes. Total blood and clinical urine analysis, ECG and brain MRI demonstrated no deviations.

Conclusions: Due to few similar cases and limited experience for their managing, it is necessary to:

– choose the wait and see approach. The excessive growth making a patient’s movements hard progresses, correcting surgical procedures and appropriate footwear are necessary,

– let the closure of growth zones be accomplished for correcting surgical reconstruction to be performed; the body part disproportionally enlarged should be surgically removed after that, generate a databank to generalize the results, and to develop drug and radiotherapy regimens.