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PubMed This is a summary of 18 peer-reviewed journal articles Updated
Endocrinology · Acromegaly

Building Your Specialized Care Team

At a Glance

People with acromegaly benefit from coordinated care through an experienced pituitary team, including an endocrinologist, skull-base neurosurgeon, neuroradiologist, and neuro-ophthalmologist. Bring MRI images, hormone results, and prior records to the first visit.

Acromegaly is a complex, multisystem condition that cannot be managed by a single doctor. Because it affects everything from your brain and vision to your heart and joints, care is optimally provided by an experienced multidisciplinary pituitary team [1][2]. These centers are not just offices with many doctors; they are integrated programs where specialists work together in real-time to tailor a treatment plan specifically for you [3][4].

The Core Specialist Team

A high-quality pituitary team should function like an orchestra, with each specialist playing a distinct and necessary role:

  • Pituitary Endocrinologist: This specialist leads your acromegaly care. They confirm the diagnosis, manage your medications, monitor your hormone levels, and screen for long-term complications like diabetes or sleep apnea [5][6]. Note that you should also keep your primary care provider for your general health.
  • Pituitary Neurosurgeon: You need a surgeon who specializes specifically in the skull base and pituitary gland, not a general neurosurgeon who mostly operates on spines or large brain tumors [7][8].
  • Neuroradiologist: A specialist who is an expert at reading pituitary MRIs. They look for subtle details like cavernous sinus invasion or the Knosp grade (a measure of how far the tumor has grown sideways), which are critical for surgical planning [9][10].
  • Neuro-ophthalmologist: If your tumor is large enough to press on the optic chiasm (where your eye nerves cross), this specialist will perform advanced testing to protect your vision [4][11].

Why Surgeon Experience Matters

When choosing where to receive care, the experience of the center and the surgeon is one of the most important factors. While there is no single absolute “magic number” that guarantees success, data suggests that higher case volumes (such as centers performing 25-50 pituitary surgeries per year) are generally associated with better outcomes and lower complication rates [12][13][14]. However, case volume is just one factor; you should ask about the surgeon’s risk-adjusted outcomes, complication rates, and how well they coordinate with endocrinologists. Don’t be afraid to seek a second opinion.

Preparing for Your First Consultation

A specialized pituitary team will need to review your entire history to make the best recommendation. Do not rely on the electronic health record to transfer everything automatically. Prepare a “consultation packet” that includes:

  1. Imaging (The Most Important): Ask the imaging facility or the new center how images can be transferred electronically. If they cannot be transferred, bring the actual images from your MRIs on a CD or digital drive, not just the written radiologist’s report.
  2. Lab History: Provide a chronological list of every IGF-1 and growth hormone (GH) result you have ever had. It is helpful to include the “reference range” for each lab, as these can vary between different testing companies [6][15].
  3. Comorbidity Records: Include reports from recent sleep studies, echocardiograms (heart ultrasounds), or colonoscopies, as these help the team understand how the hormone excess has affected the rest of your body [16][17].
  4. Pathology and Operative Notes: If you have already had surgery elsewhere, the new team absolutely needs the original pathology report and the “operative note” (the surgeon’s detailed description of the procedure) [18].

By bringing this data to an experienced multidisciplinary team, you ensure that your treatment plan is based on your complete medical picture, rather than just a single snapshot in time.

Common questions in this guide

Why does acromegaly require a multidisciplinary care team?
Acromegaly can affect hormone levels, vision, the heart, joints, sleep, and blood sugar. A coordinated team can combine hormone management, skull-base surgery planning, detailed MRI review, vision testing, and screening for related health problems.
Which specialists should be part of my acromegaly care team?
An acromegaly team commonly includes a pituitary endocrinologist, a skull-base neurosurgeon, and a neuroradiologist who specializes in pituitary MRI. A neuro-ophthalmologist is especially important when a tumor may affect the optic chiasm or vision, and your primary care clinician should continue managing general health.
How can I choose an experienced pituitary surgeon?
Ask how many pituitary and acromegaly operations the surgeon performs each year, the center’s remission and complication rates, and how care is coordinated with endocrinology. Higher surgical volume is often linked with better outcomes, but no single volume guarantees success; risk-adjusted results and a second opinion also matter.
What should I bring to my first acromegaly specialist appointment?
Bring the actual MRI images on a CD, digital drive, or electronic transfer whenever possible, not only the written report. Also gather a dated list of IGF-1 and growth hormone results with each laboratory’s reference range, plus sleep study, heart ultrasound, colonoscopy, pathology, and operative records when relevant.
What should I ask before pituitary surgery for acromegaly?
Ask whether endoscopic or microscopic surgery is recommended for the tumor’s size and location, and why. Ask how the surgeon manages risks such as cerebrospinal fluid leaks or new hormone deficiencies and how the endocrinologist will support recovery and long-term follow-up.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.How many pituitary surgeries do you personally perform each year, and how many for acromegaly specifically?
  2. 2.Does your center have a dedicated pituitary tumor board or a formal multidisciplinary conference where my case will be reviewed by multiple specialists?
  3. 3.Can you share your center's recent data on surgical remission rates and common complications, such as CSF leaks or new hormone deficiencies?
  4. 4.Which surgical approach do you recommend—endoscopic or microscopic—and why is it the best fit for the size and location of my tumor?
  5. 5.How closely do you work with the endocrinologist to coordinate my care immediately after surgery and throughout my long-term recovery?
  6. 6.Does your center have access to specialized imaging like 3-Tesla (3T) MRI or specialized pathology staining like SSTR2 if I need them later?

Questions For You

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References

References (18)
  1. 1

    Consensus on criteria for acromegaly diagnosis and remission.

    Giustina A, Biermasz N, Casanueva FF, et al.

    Pituitary 2024; (27(1)):7-22 doi:10.1007/s11102-023-01360-1.

    PMID: 37923946
  2. 2

    Multidisciplinary management of acromegaly: A consensus.

    Giustina A, Barkhoudarian G, Beckers A, et al.

    Reviews in endocrine & metabolic disorders 2020; (21(4)):667-678 doi:10.1007/s11154-020-09588-z.

    PMID: 32914330
  3. 3

    Italian Association of Clinical Endocrinologists (AME) and Italian AACE Chapter Position Statement for Clinical Practice: Acromegaly - Part 1: Diagnostic and Clinical Issues.

    Cozzi R, Ambrosio MR, Attanasio R, et al.

    Endocrine, metabolic & immune disorders drug targets 2020; (20(8)):1133-1143 doi:10.2174/1871530320666200127103320.

    PMID: 31985386
  4. 4

    Evaluating pituitary tumor management: aligning with pituitary tumor centers of excellence criteria.

    Yang JH, Wang WH, Chen HS

    Pituitary 2025; (28(5)):91 doi:10.1007/s11102-025-01563-8.

    PMID: 40813728
  5. 5

    Pituitary adenoma imaging as a determinant of acromegaly diagnosis and outcomes.

    Haberbosch L, MacFarlane J, Gillett D, et al.

    The Journal of clinical endocrinology and metabolism 2026; (111(Supplement_1)):S89-S106 doi:10.1210/clinem/dgag179.

    PMID: 42029672
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    Acromegaly.

    Dineen R, Stewart PM, Sherlock M

    QJM : monthly journal of the Association of Physicians 2017; (110(7)):411-420 doi:10.1093/qjmed/hcw004.

    PMID: 26873451
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    Outcome of acromegalic patients undergoing endoscopic endonasal surgery: collaborative French and Italian cohort, a 25-year experience.

    Baussart B, Zoli M, Passeri T, et al.

    Neurosurgical review 2025; (48(1)):654.

    PMID: 40965517
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    Postoperative Considerations Following Pituitary Surgery: A Guide for Clinicians.

    Giraldi EA, Ioachimescu AG

    Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists 2025; (31(10)):1339-1345 doi:10.1016/j.eprac.2025.06.018.

    PMID: 40581268
  9. 9

    Prognostic Factors of Acromegalic Patients with Growth Hormone-Secreting Pituitary Adenoma After Transsphenoidal Surgery.

    Taweesomboonyat C, Oearsakul T

    World neurosurgery 2021; (146()):e1360-e1366 doi:10.1016/j.wneu.2020.12.013.

    PMID: 33309643
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    Diagnosis and Treatment of Acromegaly: An Update.

    Ershadinia N, Tritos NA

    Mayo Clinic proceedings 2022; (97(2)):333-346 doi:10.1016/j.mayocp.2021.11.007.

    PMID: 35120696
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    Adenoma size and postoperative IGF-1 levels predict surgical outcomes in acromegaly patients: results of the Swiss Pituitary Registry (SwissPit).

    Kempf J, Schmitz A, Meier A, et al.

    Swiss medical weekly 2018; (148()):w14653.

    PMID: 30141524
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    Outcomes of transsphenoidal surgery for pituitary adenomas in Spain: a retrospective multicenter study.

    Paja M, Soto A, Hanzu FA, et al.

    Frontiers in endocrinology 2025; (16()):1529418 doi:10.3389/fendo.2025.1529418.

    PMID: 40060376
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    Hospital procedural volume is inversely linearly associated with complications in endoscopic endonasal transsphenoidal resection of pituitary tumors.

    Han JS, Demetriou AN, Dallas J, et al.

    Journal of neurosurgery 2025; (143(5)):1377-1386 doi:10.3171/2025.3.JNS242018.

    PMID: 40577859
  14. 14

    The experience with transsphenoidal surgery and its importance to outcomes.

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    Pituitary 2018; (21(5)):545-555 doi:10.1007/s11102-018-0904-4.

    PMID: 30062664
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    A case of a co-secreting TSH and growth hormone pituitary adenoma presenting with a thyroid nodule.

    Adams LH, Adams D

    Endocrinology, diabetes & metabolism case reports 2018; (2018()) doi:10.1530/EDM-18-0067.

    PMID: 30159148
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    Acromegaly: pathogenesis, diagnosis, and management.

    Fleseriu M, Langlois F, Lim DST, et al.

    The lancet. Diabetes & endocrinology 2022; (10(11)):804-826 doi:10.1016/S2213-8587(22)00244-3.

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    [Acromegaly and it's cardiovascular implications].

    Cadena-Obando DA, Remba-Shapiro I, Abreu-Rosario CG, Mercado M

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    An intrasellar pituitary adenoma-gangliocytoma presenting as acromegaly.

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This page explains how to choose and prepare for an acromegaly care team for educational purposes and does not replace medical advice. Discuss your diagnosis, surgeon, test results, and treatment plan with your healthcare professionals.

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