{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:48Z","timestamp":1784557068212,"version":"3.55.0"},"reference-count":10,"publisher":"Bioscientifica","license":[{"start":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T00:00:00Z","timestamp":1643673600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,2,1]]},"abstract":"<jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>The iconic photograph \u2018A Jewish giant at home with his parents in the Bronx, N.Y. 1970\u2019 by the famous American photographer Diane Arbus (1923\u20131971) shows the 2.34 m (7 ft. 8\u00bc in.) acromegalic giant Eddie Carmel (1936\u20131972) and his parents in the living room of their New York home. The picture is a typical example of Arbus\u2019 style. The relationship between the artist and the tall subject is described. A growth hormone-secreting pituitary macroadenoma was unsuccessfully treated with two cycles of pituitary radiotherapy achieving a 7000 rad cumulative dose and by incomplete pituitary surgery. Hypopituitarism was treated according to medical standards in the 1960s and 1970s. The giant patient died of increased intracranial pressure and at autopsy a residual acidophil pituitary macroadenoma was found, but also a perisellar meningioma which was most probably induced by the high dose of pituitary radiotherapy. The case report illustrates the possibilities and impossibilities of treating acromegaly 50 years ago and demonstrates the potential risks of high dose pituitary radiotherapy (in acromegaly).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Learning points<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>Acromegaly is a very old disease.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Therapy for acromegaly has evolved over the decades.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>In art museums one can come across artistic impressions of endocrine disorders.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>People suffering from disfiguring endocrine disorders like acromegaly were pre-WW2 \u2018exposed\u2019 in theaters and circuses.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>High dose pituitary radiotherapy can be associated with secondary brain tumor formation.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>","DOI":"10.1530\/edm-21-0131","type":"journal-article","created":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T12:25:54Z","timestamp":1638275154000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":0,"title":["The possibilities and impossibilities of treating acromegaly 50 years ago illustrated by the Diane Arbus photograph, A Jewish giant at home with his parents in the Bronx, N.Y. 1970"],"prefix":"10.1530","volume":"2022","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1463-5165","authenticated-orcid":true,"given":"Wouter W.","family":"de Herder","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Sector of Endocrinology, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Diane Arbus: An Aperture Monograph","author":"Arbus","year":"1972","unstructured":"Arbus DDiane Arbus: An Aperture Monograph. Ch\u00eane, 1972."},{"key":"bib2","series-title":"Diane Arbus: Revelations","author":"Arbus","year":"2003","unstructured":"Arbus DArbus DBahr MPhillips SSSelkirk N & Walker Art Center. Diane Arbus: Revelations. Random House2003."},{"key":"bib3","series-title":"Diane Arbus: Portrait of a Photographer","author":"Lubow","year":"2017","unstructured":"Lubow ADiane Arbus: Portrait of a Photographer. HarperCollins, 2017."},{"key":"bib4","series-title":"Gigantism and Acromegaly in the 20th Century","author":"de Herder","year":"2012","unstructured":"de Herder WWP\u00e9ri\u00e9 JGnodde A. Gigantism and Acromegaly in the 20th Century. Breda, the Netherlands: NPN Drukkers, 2012."},{"key":"bib5","series-title":"Gigantism. Reference Module in Biomedical Sciences","author":"de Herder","year":"2016","unstructured":"de Herder WWde Graaff Lvan der Lely AJ. Gigantism. Reference Module in Biomedical Sciences. Elsevier, 2016."},{"key":"bib6","series-title":"Metabolism: Clinical and Experimental","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1016\/0026-0495(75)90044-X","article-title":"Unsuspected meningioma in a patient with pituitary gigantism. Case report with autopsy findings","volume":"24","author":"Stock","year":"1975","unstructured":"Stock JMGhatak NROppenheimer JH. Unsuspected meningioma in a patient with pituitary gigantism. Case report with autopsy findings. Metabolism: Clinical and Experimental197524767\u2013775. (https:\/\/doi.org\/10.1016\/0026-0495(7590044-x)10.1016\/0026-0495(75)90044-X"},{"key":"bib7","series-title":"Cancer","doi-asserted-by":"publisher","first-page":"791","DOI":"10.1002\/1097-0142(195907\/08)12:4<791::AID-CNCR2820120424>3.0.CO;2-B","article-title":"Combined nonmetastasizing fibrosarcoma and chromophobe tumor of the pituitary","volume":"12","author":"Terry","year":"1959","unstructured":"Terry RDHyams VJDavidoff LM. 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