Entries in Acromegaly (2)


WWE Star's Growth-Inducing Tumor Removed

NARINDER NANU/AFP/Getty Images(NEW YORK) -- World Wrestling Entertainment star Dalip Singh, better known by his ring name The Great Khali, underwent surgery Wednesday to remove a tumor that caused his huge size.

At 7-foot-1 and weighing 347 pounds, Singh, a former police officer in India's Punjab province, made his WWE debut in 2006, and won the World Heavyweight Championship belt just a year later. But while his dimensions have earned him celebrity status, they are the result of a tumor that likely triggered long-term complications for his health.

The benign tumor developed on Singh's pituitary gland, a tiny gland at the base of the brain that produces growth hormone. The tumor caused excessive secretion of the hormone, leading to a condition known as acromegaly, which causes gigantism if the tumor is active before puberty and can be fatal if left untreated, said Dr. Joshua Cohen, an endocrinologist at George Washington University.

Despite the surgery last week, Singh, 39, is at greater risk of facing health problems such as diabetes, hypertension, heart disease and even poor vision if the tumor came into contact with the nearby optic nerves, Cohen said. In 1993, star wrestler Andre the Giant, who stood at 7 feet and 5 inches, and weighed 500 pounds, died at age 46 of congestive heart failure caused by acromegaly.

Susan Manko, a spokeswoman for University of Pittsburgh Medical Center, where Singh was operated on, said Singh was "recovering well in the hospital" and is expected to be released by Monday. Singh has declined to speak to reporters until then, Manko said.

The signs of Singh's acromegaly are instantly obvious, said Dr. Glenn Braunstein, an endocrionologist and chair of the medicine department at Cedars-Sinai Medical Center in Los Angeles — raising the questions, he added, of whether and for how long WWE knew about it, and whether treatment was put off because Singh's surging growth hormone levels were helping him become one of the most formidable wrestlers in the nation.

"The prominent eyebrows, the bulbous nose, the chin protruding, the massive ears — this is quite typical of patients with acromegaly," said Braunstein, who said he could make a clear diagnosis based on the few seconds it took him to conduct a Google image search.

WWE identified Singh's acromegaly at some time prior to his surgery through its Wellness Program, a WWE official said on condition of anonymity because he was not authorized to speak to the press about Singh.

In a statement, WWE spokesman Adam Hopkins said that "[a]s part of WWE's ongoing wellness evaluation, we are happy that The Great Khali (Dalip Singh) had successful pituitary surgery, and we look forward to him returning to the ring in the near future."

Cohen said Singh could be healthy enough to return to the ring within months, but if he does, it might be at the risk of internal bleeding at the surgical site caused by physical contact.

Dr. Joseph Maroon, who serves as WWE's medical director and led the UPMC surgical team that operated on Singh Wednesday, deferred comment to Hopkins. Dr. David Black, the Wellness Program's administrator, and Dr. Vijay Bahl, a UPMC endocrionologist who serves on the program's group of physicians, could not be reached for comment.

WWE's knowledge of Singh and other wrestlers' acromegaly could put it in a precarious legal position, said Gabriel Feldman, who directs the sports law program at Tulane Law School.

Whether WWE could be held liable for failing to address such conditions depends on the terms of its talent contracts, Feldman said, adding that WWE attorneys are known for the scrupulousness with which they guard the publicly traded but privately controlled company from liability. WWE contracts tend to tilt most of the leverage toward the company, he said.

"This may be more of a moral problem than a legal problem," Feldman said.

Still, he said, the litigation currently facing the National Football League — over players' accusations that the league deliberately withheld information about the long-term effects of concussions — may offer arguments in favor of holding WWE liable for the health problems of acromegalic wrestlers. If the NFL litigation succeeds, he said, it will likely "open the floodgate" to similar lawsuits by athletes in other sports.

WWE established its Wellness Program in 2006, after star wrestler Eddie Guerrero suddenly died of acute heart failure, a result of arteriosclerotic cardiovascular disease. Under the program, Aegis Sciences Corporation annually tests performers for drug use, including steroids, and cardiac problems. In August 2007, Montel Porter, whose real name is Hassan Assad, was diagnosed with a potentially fatal heart disorder in a routine checkup.

Dr. Bryan Donohue, a UPMC cardoiologist and WWE's cardiovascular consultant since 2008, said in his experience, WWE has never put commercial interests above the health of its performers, adding that many WWE executives are former wrestlers.

"The narrative is obvious, that the interests of WWE are antithetical to those of the talent, but I've found that they've been very responsive to things I've asked them to do," Donohue said. "I've never experienced any pushback on any issue."

While Donohue said he could not comment on Singh's case, he said the decision to operate on a pituitary tumor does not follow reflexively from a diagnosis of acromegaly. The timing, especially for adults, can be influenced by a range of factors.

Braunstein, the Cedars-Sinai endocrinologist, said he has seen several acromegalic patients who have refused surgery and even a growth hormone-reducing medication in hopes of preserving their gigantism. When he tells them that acromegaly shortens life expectancy, they often "shop around for other doctors," he said.

Copyright 2012 ABC News Radio


New Medication Helps Woman Living with Acromegaly

ABC News(LAS VEGAS) -- At 6-foot 11-inches tall and 344 pounds, Tanya Angus, who has a rare disease that causes gigantism, may finally have slowed her uncontrollable growth.

The Las Vegas 32-year-old was so large that her family didn't know how they would transport her to a California hospital last October, where they hoped to find treatment. A former swimmer, she could no longer enjoy the pool because it took several people to get her in the water.

Angus had swelled to 450 pounds, but because of this new medication -- Somatuline -- she has dropped 100 pounds and her growth hormone levels have plummeted, as well.

"My heart is enlarged, everything in my body is enlarged," Angus told ABC's affiliate KTNV.

Her heart, lungs, joints and other parts of her body have also grown under the strain of this rare disease -- acromegaly.

Now, Angus is receiving a bumped-up dose of one drug, which doctors are monitoring to see if her case -- one of the worst in the world -- can help others. She is now in a brand new medical textbook for nursing students.

Since then her levels of growth hormone have dropped from 1,000 to 602, according to her mother. When they reach 300, she can consider herself on maintenance.

Acromegaly is a rare pituitary disorder that causes the body to produce too much growth hormone. It affects about 20,000 Americans. Fluid accumulates in the body, causing stress on multiple systems in the body. Patients are more prone to cardiac conditions, hypertension and diabetes.

"They are in a lot of pain because they get severe headaches and their joints can be swollen and develop premature osteoarthritis," said Dr. Laurence Katznelson, professor of medicine and neurosurgery at Stanford University Hospital in California and medical director of its pituitary center. "Their mortality rate is two to four times greater than the general population."

About 95 percent of the time, the condition is caused by a non-cancerous tumor on the pituitary gland, according to Katznelson, who did not treat Angus. In her case, the tumor is wrapped around her carotid artery, and is inoperable. The disease is not hereditary and happens, "sporadically," he said.  By the time many are diagnosed, patients have a whole host of medical issues.

Katznelson serves as medical advisor to the online Acromegaly Community, which invited Angus to speak at their April convention. There, she told others how to get grants to help pay for medications, which can cost as much as $100,000 a month.

Copyright 2011 ABC News Radio

ABC News Radio