Real giants!?

As a petite person (5’3”), I have considered many of those around me very tall. I remember being the shortest one out of all of my friends, and I always felt like they were giants.

However, after visiting Musée Fragonard within the first week of my Neuroscience and Behavioral Biology (NBB) Emory University study abroad trip in Paris, I realized just how tall a true “giant” was. Musée Fragonard is a museum full of anatomical parts of animals or humans preserved for veterinary students and public. During my visit, I was able to see an anatomically-correct model of a patient’s hand who was diagnosed with gigantism.

Comparing my tiny hand to a model of someone diagnosed with gigantism during the museum visit
A close-up of the large hand

As you can see, the model is more than three times as big as my little hand. This made me wonder: How do you get gigantism?  Just how “big” do you have to be?

Interestingly enough, gigantism originates in the brain. It is nearly always caused by a tumor of the pituitary gland, a gland located at the base of the brain known for secreting a wide variety of hormones. I was not surprised to learn that one of these hormones was growth hormone (GH). In gigantism, the tumor causes the pituitary gland to secrete excess GH during childhood that leads to excessive linear growth since epiphyseal growth plates are open (Eugster & Pescovitz, 1999).

Brain slices on display at the museum, many of which show the pituitary gland
A general overview of the location of the pituitary gland, from the American Association of Neurological Surgeons

There is no specific height one must reach in order to be diagnosed with gigantism since many factors play a role into determining how tall a person will be including genetics, diet, stress, and the size and location of the tumor. If one believes a child may have gigantism, there are many symptoms that may be present that are uncharacteristic of a normal growth spurt and should be checked by a medical doctor. Some of these symptoms include excessive sweating, severe headaches, delayed puberty, irregular menstrual periods in girls, and very large hands and feet. In order to test for gigantism, the doctor will most likely order a blood test to measure the levels of GH and insulin-like growth factor 1.

Once diagnosed, treatment is usually very effective (most likely removal of the tumor), and the patient can lead a healthy life. However, it is of utmost importance that gigantism is treated as early as possible since treatment delay has been found to increase final height and symptom burden (Rostomyan et al., 2015).

It always amazes me how much power the brain has– one tiny gland helps control the entire size of a human being! This was a fascinating trip, and I gained insight into the brain and a unique condition that I never knew existed before.

Sources:

American Association of Neurological Surgeons. (n.d.). Pituitary Gland and Pituitary Tumors. Retrieved June 1, 2018, from http://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Pituitary-Gland-and-Pituitary-Tumors

Eugster, E. A., & Pescovitz, O. H. (1999). Gigantism. Journal of Clinical Endocrinology & Metabolism,84(12), 4379-4384. doi:10.1210/jc.84.12.4379

Rostomyan, L., Daly, A. F., Petrossians, P., Nachev, E., Lila, A. R., Lecoq, A., . . . Beckers, A. (2015). Clinical and genetic characterization of pituitary gigantism: An international collaborative study in 208 patients. Endocrine-Related Cancer, 22(5), 745-757. doi:10.1530/erc-15-0320

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