The doctor imagined a possibility of a brain disease. (Representational Image: Unsplash)
A doctor from Hyderabad's Apollo Hospital recently narrated how he detected a benign tumour in a woman. Dr Sudhir Kumar, a neurologist revealed how he detected the tumour, one of the biggest indicators was that her shoe size went up by two counts in two years.
In a series of tweets, Dr Kumar shared that woman's husband was his patient initially, he complained of back pain. Incidentally, the doctor soon observed his wife's face who was sitting beside her husband. The doctor described, "Her nose and lips appeared a bit larger than usual. When she smiled, her teeth were a little spaced out and her tongue was also a little larger than normal. She spoke with a little heavy voice."
Check out the tweet here:
The doctor imagined a possibility of a brain disease. He then asked her, "Don't mistake me, but has your shoe size increased?" Her eyes almost popped out, the doctor shared. She replied with a shocked expression- "doc, yes! It has increased from 5 to 7 in the past two years. Don't everyone's feet become larger as they grow older?"
The doctor responded, "Feet do grow in childhood and adolescence but at your age- I am afraid, they don't grow." The doctor shared that he was certain about the disease and asked her to do a blood test and come back for review.
The blood test showed insulin-like growth factor 1 (IGF 1) was very high, suggestive of excess growth hormone (GH) secretion. "Since GH is secreted from #pituitary gland in the brain, I asked for MRI Brain, which confirmed the diagnosis of pituitary adenoma (a benign tumour)," the doctor wrote.
Dr Kumar made the final diagnosis of acromegaly due to excess GH secretion from a pituitary adenoma. He further wrote that the woman was operated and the tumour was removed through the nose route, without opening the brain.
Talking about her recovery, the doctor wrote, "She made an excellent recovery. Facial features, tongue & speech improved. IGF 1 level normalized after 12 weeks. She required medications for mild diabetes. She possibly had the disease for two years before it was diagnosed. She was lucky to escape from serious complications."
He shared a message for the readers, "Increase in shoe size (due to feet becoming larger) and changes in facial appearance in adults could be features of acromegaly (GH excess). Initial diagnosis can be made by a simple blood test- IGF 1. Early treatment can prevent serious complications."