A new review by Andrea Giustina, MD, and Annamaria Colao, MD, PhD, updates the pathophysiology and disease course of acromegaly, focusing on the general clinician’s key role in early diagnosis and management. At diagnosis, approximately 70% of patients with acromegaly have identifiable macroadenomas that may have grown laterally and extend into the cavernous sinus. In the large Liège Acromegaly Survey, physical changes were most often what led patients with acromegaly to seek medical evaluation and care, especially the development of dysmorphic facies (in 21.5% of cases), which were associated with macroglossia, dental diastema (gaps), mandibular overgrowth, and prognathism, and enlarged hands and feet (in 13.6%). Headache (in 7.5% of cases), asthenia (in 5.9%), and excess perspiration (in 2.0%) also led patients to seek care. Coexisting conditions noted at diagnosis included thyroid enlargement (in 34.0% of cases), hypertension (in 28.8%), diabetes (in 27.5%), sleep apnea (in 25.5%), and cardiac hypertrophy (in 15.5%) (seen in figure). Learn more in the Review Article “Acromegaly,” from San Raffaele Vita-Salute University (@MyUniSR), IRCCS San Raffaele Hospital (@SanRaffaelespa), and @UninaIT: nej.md/3JPVdBg