More than just a polyp: Hidden acromegaly behind a giant colonic mass.

Acromegaly is a rare endocrine disorder characterized by chronic hypersecretion of growth hormone and insulin-like growth factor-1, leading to an increased incidence of colonic polyps and neoplasia. This report describes a 38-year-old man who presented with gastrointestinal symptoms and was found to have a giant sessile polyp in the colon. Routine preoperative evaluation revealed elevated serum insulin-like growth factor-1 and unsuppressed growth hormone levels, leading to the diagnosis of acromegaly, which was confirmed by a pituitary MRI that showed a macroadenoma. This case highlights that unusually large colonic polyps in younger patients should prompt consideration of systemic etiologies, including endocrine disorders. A multidisciplinary approach, integrating gastroenterological and endocrinological assessment, is essential for early diagnosis and management to reduce morbidity.