Pituitary Adenoma increased in Size in 8months?

[pinkyr]

Hi,

I was first diagnosed of pituitary microadenoma on 30th March 2012 and MRI Brain report said its approximately 5-6mm and abutting towards optic chiasma. I had on and off headaches during this period. My TSH at that time was 7.3, Prolaction 120 and rest normal. I was advised Thryonorm 50mg and prolactin was 12 and TSH 2.32 in few months. again the headaches started, got the blood tests done and Prolactin 55 so doctor started carbegoline .5mg once a wk and increased thyronorm dose to 75mg and advised for repeat MRI.

My Latest MRI Brain of Nov 2012 with sella with contrast dye suggests lesion in pituitary gland approx 12.5 x 5.2mm in coronal plane and 6.1 and 4.3 mm in sagittal plane. Post contrast dynamic study of pituitary gland was performed. It shows poorly enhancing lesion in posterior aspect of anterior pituitary gland in the midline as compared to the rest of pituitary gland. Optic Chiasma appears normal. Rest normal.

Currently, I have on and off headaches, frequent urination problem, hair loss, skin acne, fatigue.

I want to know does stress (emotional) causes such sudden increase in size of pituitary adenoma? Also as two measurements are given of adenoma -  approx 12.5 x 5.2mm in coronal plane and 6.1 and 4.3 mm in sagittal plan - does it mean the adenoma is increased in size? Is it microadenoma or macroadenoma?

Kindly advise.

[Daniel M Prevedello, MD]

Dear Pinkyr

I am not allowed to write my email address on this forum. Please send a disc to the address I wrote above and I will review the imaging free of charge.

Although it is not a formal indication for surgery, a pituitary adenoma that has been growing is a relative indication for surgery. It is a prophylactic way to avoid vision loss in the future.

[pinkyr]

Thank you all for your replies.

Dear Dr. Daniel,

Kindly send me your email id and I shall send you the dropbox login credentials where i have uploaded the MRI Scan report. I got it re-interpreted from Radiologist and he suggested the size of the lesion to be 9.5mm*5.3mm*4.8mm and resultant mild displacement of left optic nerve.

I have no vision changes clinically (though perimetry i.e. visual field changes seen in left eye) - Do I still need surgery even in absence of clinical symptoms?

[Racquelb]

I have a pituitary gland problem as well I was put on dosnix to shrink it ...my prolactin level was crazy high once I took the medication it dropped quickly ... Let me know how u make out

[Daniel M Prevedello, MD]

Dear Pinkyr

I agree with Rumpled. Pituitary adenomas tend to grow. Your seems to be growing faster than usual and for that reason may very likely need to come out.
I will be glad to revise your films free of charge.
If you would like to send your discs you can send them to:

Daniel Prevedello, MD
410 W 10th Avenue,
N1011 Doan Hall, Neurosurgery
Wexner Medical Center
Columbus, OH
43210

Thank

Daniel

[rumpled]

Your tumor has grown from a micro-adenoma to a macro-adenoma.

Stress does not cause tumors to grow. The cause, as far as I know, is unknown.

I would really find a pituitary center and a neuro-endo so that you can get more testing. You may or may not have a prolactinoma or you may have a non-secreting tumor with mass effect issues. You want to get this treated ASAP before it gets larger. Your tests are not complete enough to really show type of tumor.

In the patient brain/pituitary tumor health pages, there are resources for research and to find doctors. The expert here is also a fine option for a surgeon. Just make sure you get a surgeon with a lot of surgeries under his belt - skill is important here.