# Diagnostic Delay in Acromegaly Due to Overlapping Features With Polycystic Ovary Syndrome: A Case Report

## TL;DR

A woman initially diagnosed with PCOS was later found to have acromegaly, highlighting the importance of considering rare endocrine disorders in similar cases.

## Contribution

This case report highlights diagnostic challenges in acromegaly due to overlapping symptoms with PCOS.

## Key findings

- A 33-year-old woman initially diagnosed with PCOS was later found to have acromegaly.
- Delayed diagnosis led to complications requiring surgical intervention and ongoing therapy.
- The case underscores the need for comprehensive assessments in women with menstrual and hyperandrogenic symptoms.

## Abstract

Acromegaly is a rare endocrine disorder marked by excessive secretion of growth hormone, typically as a result of a pituitary adenoma. This condition in female patients often presents with features that may overlap with polycystic ovary syndrome (PCOS), potentially leading to misdiagnosis or delayed diagnosis. This case study looks at a 33-year-old woman initially diagnosed with PCOS due to hirsutism, secondary amenorrhea, and features of polycystic ovaries on ultrasound. One year later, she experienced progressive visual disturbances and headaches, leading to the discovery of a large pituitary macroadenoma via MRI. Subsequent hormonal evaluation revealed elevated insulin-like growth factor 1 (IGF-1) and growth hormone levels, culminating in a diagnosis of acromegaly. The patient underwent successful endoscopic debulking of the adenoma with no residual disease detected on subsequent imaging. Post-operative management included Lanreotide therapy for persistently elevated IGF-1 levels. This case emphasises the importance of considering acromegaly in women with menstrual irregularities and hyperandrogenism, highlighting the need for comprehensive assessments to facilitate early diagnosis and address potential complications, such as vision loss and fertility issues.