In a large review of ectopic GHRH secretion with acromegaly, 43 out of 96 cases were reported as pituitary enlargement, 20 as adenomas, 18 normal on imaging, 10 as unclear lesions, 3 as empty sellae, and 2 as microcystic lesions (2). The gene discussed is GHRH; the disease is empty sella syndrome.