Acromegaly is a disease of the whole organism in which everything but the central nervous system enlarges. Although the diagnosis is often made coincidentally, the patient usually presents complaining of a change in appearance of the face, hands or whole body, headaches, sweating, goitre or symptoms related to renal stones. Early diagnosis is important but this depends on a high index of suspicion. It often helps to look at old photographs, but a delay in diagnosis of many years may occur (Fig. 3.4). The condition is most frequently diagnosed in the third decade but may be found from the teenage years up until the eighth decade.
