(A) MRI of GH-secreting pituitary macroadenoma depicting lateral tumor extension into cavernous sinus and dorsal elevation of optic chiasm (coronal image). (B) Image of limestone relief portrait of Egyptian Akhenaten, circa 1365 BCE, showing jaw prognathism and thickened lips. Reproduced with permission from Wikipedia (http://commons.wikimedia.org/wiki/File:ReliefPortraitOfAkhenaten01.png). Source: Altes Museum, Berlin, Germany. (C) Jaw prognathism and mandibular overbite and (D) widened incisor tooth gap in two acromegaly patients. (E) Governor Pio Pico of California in 1858. Note acromegaly facial features and mild left proptosis consistent with cavernous sinus tumor invasion. Reproduced with permission from Pituitary (S40). (F) Dolicomegacolon in acromegaly as visualized by CT colonography. The colonic centerline (red) is visible. Yellow arrow indicates a diverticulum of the transverse colon. Reproduced with permission from the Journal of clinical endocrinology and metabolism (125).