Editor's note: This popular story from the Daily Briefing's archives was republished on June 8, 2023.
When a 53-year-old woman noticed she was suddenly "hot all the time and sweated like crazy," she assumed she was going through menopause—until tests revealed a rare diagnosis, Lisa Sanders writes for New York Times Magazine.
When the 53-year-old woman studied her face in the bathroom mirror, she noticed "[s]he had bags under her eyes, and the skin around them was puffy. Her face shone with sweat from near-constant hot flashes," Sanders writes. "She hardly recognized the face that looked back at her."
In addition, the woman's hands had grown so large she was unable to wear rings. Her feet had also grown from a women's size eight-and-a-half shoe to a men's size nine-and-a-half shoe. Similarly, her tongue had grown so large that she frequently bit it. She was also experiencing sleep apnea and high blood pressure.
Even though she had been thin her entire life, she needed a knee replacement at 49. She was also "hot all the time and sweated like crazy," Sanders writes.
Initially, the woman attributed her symptoms to menopause.
Then, she noticed that the teeth on the right side of her jaw did not touch anymore, which made it difficult to chew her food—a problem she'd had for most of the previous year.
When she could no longer tolerate it, she went to her dentist, Robert Souferian, who confirmed that her bite had shifted. He reassured her that this happened occasionally and filed her teeth to improve the fit. "That worked beautifully — for a few months," Sanders noted. "But it was now clear that her jaw had shifted again."
Soon after, she returned to Souferian's office and asked him to file her teeth again. "That doesn't make sense," he told her. When he examined her mouth and jaw, he could see that her bite had in fact shifted, but he could not determine the cause. Souferian was concerned that the woman could have a growth or tumor inside one of her temporomandibular joints.
"She wasn't tender there, and he couldn't feel anything," Sanders writes. "Still, it was a possibility he couldn't ignore."
Souferian referred her to a colleague who performed a 360-degree X-ray—but the results came back normal. She was then sent for an MRI of her jaw.
A few days later, she learned that there was no tumor on her jaw. However, the dentist informed her that the radiologist saw a lesion on her pituitary gland and advised her to see a neurologist.
The neurologist determined that the woman needed an MRI of her brain. After the scan, he confirmed that she had a large, non-cancerous lesion on her pituitary.
"You don't have to get this done tomorrow," the neurologist told her, "but it should be removed within the year."
He told the woman she would need to see three more doctors, an ophthalmologist, an endocrinologist, a neurosurgeon.
When she went to visit Joan Cantero, the endocrinologist, she learned that the mass was roughly the size of a marble—twice the size of the pituitary gland. While Cantero agreed that the mass would need to be removed, she told the patient that they would first need to see if it was making any of the pituitary's hormones, Sanders writes.
After hearing the woman's symptoms, Cantero suspected she had an overproduction of growth hormone that results in the unregulated enlargement of the soft tissues in the body—a disorder called acromegaly.
"The patient was a small woman, but, the doctor noticed, her hands and feet were huge," Sanders writes.
To help confirm her suspicions, Cantero asked the woman to take off her mask and show her some old photos. According to Sanders, "[t]he difference in the two faces added to Cantero's clinical suspicion."
To determine whether the woman had acromegaly, Cantero sent her to the lab where she drew several tubes of blood. Two weeks later, when the patient returned to the endocrinologist's office, she learned that her growth-hormone levels were almost five times above the normal range, confirming Cantero's suspicions. Two weeks, later the woman had an operation to remove the mass.
According to Sanders, just two days after the patient left the hospital, she was once again able to fit into her mother's size eight-and-a-half shoes.
"She's no longer hot and sweaty all the time," Sanders writes. "It sounds minor," the woman told Sanders, "but that was one of the worst parts of the whole ordeal."
One year after her surgery, the woman said she looks at least five years younger. "Her acquaintances suspect a face lift," Sanders writes. "Her friends know it was a different kind of surgery."
"Best of all, she has watched as her face has slowly reverted back to the one she knew so well," she adds. (Sanders, New York Times Magazine, 6/15)
Create your free account to access 2 resources each month, including the latest research and webinars.
You have 2 free members-only resources remaining this month remaining this month.
Never miss out on the latest innovative health care content tailored to you.