Gigantism

Gigantism or giantism, (from Greek gigas, gigantos "giant") is a condition characterized by excessive height growth. Gigantism is not a currently used medical term and there is no precise definition of the degree of tallness which qualifies a person to be termed a "giant." The term has been typically applied to those whose height is not just in the upper 1% of the population but several standard deviations above mean for persons of the same sex, age, and ethnic ancestry. Typical adult heights of Americans and Europeans to whom the term might be applied are 215 - 260 cm (7.5 - 8.5 feet), although the term is rarely applied to basketball players and those whose heights appear to be the healthy result of normal genetics and nutrition.

Pituitary gigantism

Pituitary gigantism due to growth hormone excess is the single condition which accounts for nearly all cases of pathologic extreme height. The excess growth hormone usually results from oversecretion by a group of somatotrope cells of the anterior pituitary gland (termed a "somatotrope adenoma"). These cells do not respond to normal controls of growth or function. They grow very slowly, so that for many years the only effects of such an adenoma are the effects of excessive growth hormone.

The primary effect of growth hormone excess in childhood is excessive growth, but the tallness is accompanied by a characteristic body build recognizable to an endocrinologist. The typical body build involves heavy, thick bones, with large hands and feet and a heavy jaw. Once puberty is complete and adult height is achieved, continued thickening of the skin and growth of the jaw results in a combination of features referred to as acromegaly. Unfortunately, over decades such an adenoma may reach a large enough size (2 cm or more in diameter) to cause headaches, impair vision, or damage other pituitary functions. Many years of growth hormone excess can cause other problems as well.

If pituitary gigantism or acromegaly are suspected by a physician, the simplest diagnostic screening test is measurement of insulin-growth factor 1 in the blood. This is usually quite elevated but levels must be interpreted in relation to age and pubertal status. Additional confirmatory testing may include magnetic resonance imaging (MRI) of the pituitary to look for a visible adenoma, and suppressibility of growth hormone levels by glucose. Treatment depends on the size of the adenoma and may involve removal by a neurosurgeon, drugs such as octreotide or bromocriptine, or radiation. Treatment is discussed in more detail in the acromegaly article.

Childhood pituitary gigantism is a rare condition, and those affected are often unusual enough to attain a degree of celebrity status (e.g., André the Giant) Acromegaly is the term used for the condition of growth hormone excess when it occurs in adults. Acromegaly is a far more common disease in adults than pituitary gigantism is in children.

By far the most famous sufferer of gigantism was André the Giant (May 19, 1946 – January 27, 1993) who was a professional wrestler and actor. Born André René Roussimoff in Grenoble, France. His great size was a result of acromegaly, or excessive growth hormone, and led to him being dubbed "The Eighth Wonder of the World."

André was one of the best known and most respected professional wrestlers in the world. Born to French parents of Bulgarian descent in a small farm near Grenoble, he left home in his adolescence to become a pro wrestler. He was billed at a height of 7'5" (2.26m) early in his career and 7'4" (2.24m) in his WWF days with a weight which ranged from 400 to 520 pounds. It has been said André was closer to 7'1" (2.16m) in his early adult years and roughly 6'10" (2.08m) in his most popular WWF reign, due to back surgery and posture problems. Nevertheless, the sight of him alone was enough to draw huge crowds in a day when there were only a handful of people over 6'6"

Since his death He has since become an ironic icon, stemming in part from a series of ubiquitous André the Giant Has a Posse, now known as "Obey Giant", art, which can be found on street corners and building walls in cities big and small all over the world.