Swollen Hands and “Fist Sign” in Acromegaly

A 38-year-old Japanese man without any significant past medical history was admitted to our hospital for evaluation of fatigue. Physical examination showed remarkably protruding lower jaw and enlarged nose. His hands and fingers were widened, thickened, and stubby (Figure 1A ). When asked to clench his fists, he was not able to cover his fingernails with the center of the palms (Figure 1B). Magnetic resonance imaging of the brain revealed an...