IGF1 and acromegaly: In addition to causing tumor compression symptoms such as headache, vomiting, blurred vision, and visual field defects, GH-PitNETs leads to endocrine and metabolic disorders due to the long-term excessive secretion of growth hormone and insulin-like growth factor-1 (IGF-1), resulting in conditions such as acromegaly in adults and gigantism in children3,4.