Pituitary tumor (causing acromegaly) growing downwards toward the sphenoidsinus instead of upwards, therefore not causing visual deficits.-already in childhood. later he continued to overproduce gh, so he developedacromegaly (looking like shrek). later all organs can enlarge, so he had cardiacproblems, liver and spleen enlargement, and other symptoms related to increased ghproduction (diabetes). for an unknown reason (possible relation to his childhood headtrauma and infection) the tumor is growing downwards, toward the sphenoid sinus, andthen towards the nasal cavity blocking his nasal breathing. the lack of chiasmalcompression (which is usually associated with pituitary tumors) explains why he did nothave visual field deficit.