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Female acromegalic patient, before symptoms were recognized

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Photograph taken 3 years before death, before symptoms of acromegaly were noticed. Incipient acromegaly is suggested by the "globular end of the nose, the heavy orbital arches, and the prominent malar eminences. The inferior maxilla, though somewhat large and heavy, does not yet show the prognathism usually present in the disease. The thick lips and the heavy lobe of the left ear are perhaps early evidences [sic] of the process." (Source: Brooks H. Acromegalia. Arch Neurol Psychopathol 1898;1[3]:485-678. Plate I, figure 2.)