Open Access Highly Accessed Open Badges Case report

Mandibular prognathism caused by acromegaly – a surgical orthodontic case

Martin Gosau1, Corinna Vogel2, Antonios Moralis1, Peter Proff3, Johannes Kleinheinz4* and Oliver Driemel1

Author Affiliations

1 Department of Cranio-Maxillo-Facial Surgery, University of Regensburg, Regensburg, Germany

2 Institute of Pathology, University of Regensburg, Regensburg, Germany

3 Department of Orthodontics, University of Regensburg, Regensburg, Germany

4 Department of Cranio-Maxillofacial Surgery, University of Münster, Münster, Germany

For all author emails, please log on.

Head & Face Medicine 2009, 5:16  doi:10.1186/1746-160X-5-16

Published: 6 August 2009


A 22-year-old man presented for orthodontic surgery because of mandibular prognathism. Clinical symptoms suggested acromegaly, and diagnosis was verified by an endocrinologist as well as by radiograph. Bilateral mandibular prognathism often represents the first and most striking physical characteristic of acromegaly; usually, it is also the main reason why patients seek help from orthodontists or maxillo-facial surgeons. This case report recapitulates the clinical and histopathological findings in pituitary growth hormone (GH) adenomas and emphasises their importance in surgical orthodontic planning. Mandibular prognatism, macroglossia and abnormal growth of hands and feet represent strong indicators for the diagnosis of acromegaly. This disease and its complications not only affect the entire body but increase mortality if the pituitary gland tumour remains untreated.