Symptoms: phenotypical features of acromegalyImaging: pituitary tumor of 10 x 14 mm in MRIDiagnosis: acromegalyTherapeutic approach first line: long-acting somatostatin analogue with subsequent transsphenoidal resection of the tumorHistopathological examination: pituitary somatotropic adenoma (immunohistochemical staining: GH+, PRL+/-, Ki-67 <1%)Follow-up: IGF-1 concentration was within the normal range, although there was no GH suppression in the oral glucose tolerance test. MRI showed no tumor recurrence. Here, IGF1 is linked to pituitary tumor.