17 months after surgery, due to inadequate control of acromegaly on octreotide LAR (January 2009: GH = 7.5 ng/ml, IGF-1 = 292 ng/ml; July 2009: IGF-I = 231 ng/ml), pegvisomant (10 mg/day) treatment was started. This evidence concerns the gene IGF1 and acromegaly.