[Chronic elevation of IGF-1 concentrations in a 54-year-old female with acromegalic appearance and somatoform disorder as a challenge to medical opinion].

A 54-year-old woman was referred to the psychiatric clinic with complex somatic whole-body complaints. In absence of organic findings, the diagnosis of somatoform disorder (somatization disorder ICD 10 F45.0) was made. Additionally, due to the typical appearance and chronically elevated IGF-1 (somatomedin C) concentrations, the critical diagnosis of acromegaly was postulated, although no hypophyseal adenoma was detected. The patient was variously assessed and 16 medical and rehabilitation opinions were given with regard to invalidity, particularly by orthopaedic and neurologic specialists. The results varied, even diametrically opposed. However, somatoform disorders or acromegalic appearance and possible medical consequences were not considered sufficiently. The case report encourages experts to deal with complex psychosomatic complaints objectively and unemotionally in medical opinions.