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Extracted from text ... case report a 36-year-old man presented with a 3-year history of headaches, visual deterioration, and hypothalamic features, including somnolence and compulsive eating, which are unusual in acromegaly. examination revealed both generalised and central obesity, coarsened facial features, acanthosis nigricans, skin tags and large hands and feet (Figs 1 and 2), and also marked loss of visual acuity. pituitary MrI (Fig. 3) demonstrated a large tumour. Because the differential diagnosis included a pituitary adenoma and a meningioma, a biopsy was undertaken. this showed a mammosomatotroph cell adenoma, immunocytochemically positive in all cells for growth hormone (GH) and prolactin (Fig. 4). ..
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