PITUITARY MACROADENOMA

[SHENAAZ]

Hi, my husband recently found out that the approx. size of the enhancing mass was 2.2cm in longitudinal extent, 1.9cm AP and approx. 1.6cm in transverse diameter.  The mass extended superiorly into the suprasellar cistern and was slightly lobulated in appearance at its superior surfance.  The pituatary stalk itself could not be demonstrated on the sequences and the cavernous sinuses were well demonstrated with normal appearances and without involvement with the cavernous sinus.  The scans through the pituatary gland region does reveal the mass positioned within the pituatary fossa which was intermediate signal intensity on the T1 study, high signal intensity on the T2 study and did enhance fairly intensely with contrast medium on the post Gadolinium studies.  The internal carotid artery was well demonstrated within the cavernous sinuses.  Pse. explain how big is this tumour.  What is the best treatment option.  Regards, SHENAAZ


This discussion is related to Acromegaly My MRI results Please tell me what you think.

[SHENAAZ]

The numerous blood tests.  What is a good time of the day to do the tests.

[rumpled]

My doc has me do mine 8am fasting - fasting for 8 to 12 hours. Some tests though may need to be at different times.

I found a center - I will PM it to you.

[SHENAAZ]

Thanks so much, really appreciate it.  Await to hear from you.

[SHENAAZ]

Thank you so much for info.  contacted someone at PICOMSA.  Awaiting to hear from them.  All blood tests are normal except of Testo reading 108 and the reference is 180 - 739 which is low.  Now I am more confused.  What type of tumour is this.  Does not look like Prolactin?

[rumpled]

Some tumors cause high readings - that means the tumor itself is secreting. When the hormone is low, the tumor can be impeding the hormonal secretion either by pressure or another hormone interfering - often those with Cushing's (elevated cortisol) have low testosterone. That is why it is important to get lots of hormones tested and the entire loop. Hormones work this way - the hypothalamus signals the pituitary, the pituitary signals the gland and then the gland secretes and signals back completing the loop. Hypothalamus issues are rare so it helps to test the pituitary to gland loop to see what is the real cause of the issue. Multiple hormones can be involved - like in prolactin type tumors, androgens (estrogen, testorones LH FSH dhea sulfate sex binding hormone) should all be tested. Keep in mind that there are many forms of testosterone as well so make sure they do bio-available so it captures all the types - so it pays to know the tests (in some cases better than the docs) so you get tested effectively.

It is very confusing. I hope you find a good doctor - just make sure you get copies of everything.

[SHENAAZ]

Thank you so much for your advice.  Just consulted with neurosurgeon who suggested surgery is the first line of treatment for a non-functioning pituitary adenoma.  We now go back to SKILLS.  Its getting more complicated than I thought.