Endothelial dysfunction and vascular abnormalities in acromegaly. A case report.

In patients with acromegaly, the pleiotropic effects of GH and IGF-1 have been associated with the development of endothelial dysfunction and vascular abnormalities. We present the case of a 45-year-old male diagnosed with acromegaly. Magnetic resonance imaging identified a marked dilatation and medialization of both cavernous internal carotid arteries (ICA), leading to a narrow intercarotid distance, a phenomenon known as "carotid kisses". This vascular alteration has been described in greater proportion in patients with acromegaly. The anomalies that are also present with greater prevalence in these patients are: aneurysms of the ICA, protrusion of the ICA into the sphenoid sinus, narrow intercarotid distance, fusiform dilatation of the ICA and dehiscence of this artery in the bony canal. The presence of such alterations increases the risk of injury to the ICA. Pre-surgical detection of such abnormalities is essential to ensure the safety of the surgical approach.