Conversely, gigantism is an extremely rare occurrence in the context of MEN1 and MEN4, and then with a female preponderance; rarely, acro-gigantism may be diagnosed in adolescence and young adulthood in the context of other genetic disorders, such as CCS, MAS, 3Pas, MAX-associated tumours, NF1, and the recently identified PAM variants. This evidence concerns the gene MAX and neoplasm.