A patient 48 years old Resident of Pokhara, Nepal reported to Medical OP of Manipal Medical College Pokhara with complaints of severe headache getting more and more frequent. It is noticed that the man's hands and feet are getting large. He had to take the help of goldsmith to remove his ring. Which had become very tight. He complained that he is forced to change his cap and shoes every two years. Compared to his brothers his height has increased. He frequently has sleep apnoea.
Serum growth hormone were tested and found to be elevated. A pituitary macroadenoma 1.2 cms in diameter was detected by MRI. X-ray chest shows cardiomegaly. The patient was advised surgery which he refused. What is next step of management? Suggest management for this case of Acromegaly.
