Normally a pituitary lesion will not show up on a CT unless it is large... Yours is large.
It has grown up and towards the optic nerve. You have not said if you have optic issues but if not, it may happen.
There is a pituitary organization for South Africa and we have had another patient who posted here for her husband find a doctor and get good care. I wil try to find the post but do search for the center. You need those specialists. Get copies of everything.
I am a skull base and pituitary surgeon in the US and happened upon your post. The results of your CT are vague and can be the result of a few things - either a pituitary tumor, a craniopharyngioma, an aneurysm, or potentially something else. 22.3mm in height almost guarantees that it is in contact with the optic nerves or chiasm - which are the nerves for vision. The evaluation, workup, and treatment is not simple and generally requires a team of physicians - endocrinologists, neurosurgeons, ophthalmologists, and ENT-otolaryngologists. I strongly suggest you find a tertiary care center with high level care and expertise to address this problem. Unfortunately, I am not familiar with South Africa, but if you are able to travel to the US - I can recommend several places that are reputable.
Thanks skullbase for the reply.
I will be going for the MRI on Tuesday, so i think i will have a better idea of what really is going on. In the meantime i am just reading and finding as much info as i can about this condition.
I did find a neurosurgeon in Cape Town, that is also a professor at and he also works at GrooteSchuur Hospital. I have send him an email and is awaiting a reply. GrooteSchuur is also a teaching hospital.
What is the difference between a pituitary tumor and a craniopharyngioma? How would one know if you have one and not the other. I am waiting to see the doctor now. Have done the MRI scan. He will be sharing the results with me. And I think my options.
My nerves is killing me.
I went for the MRI today. It reads as follows.
A homogeneously T1 intermediate signal intensity, T2 slightly hyper intensive mass arises out of the pituitary fossa expanding the pituitary fossa more to the left of midline with suprasellarextention, with dimensions of 2.3cm in supero-inferior dimension, 2.2cm in traverse dimension and 1.8cm in AP dimension.
This exerts mass effect on the optic chasm which is bowed superiority. There is some lateral bowing of the wall of the left cavernous sinus and I suspect there may be left cavernous sinus invasion and encasement of the Intracarvernous portion of the left ICA.
There is no evidence of pituitary apoplexy. There is no typical features to suggest that this lesion represents an aneurysm and is most likely a pituitary macro-adenoma.
There is a single spot of right periventricular white matter focal hyper intensity which is of dubious significance. Normal ventricles with no hydrocephalus identified. Preserved grey/white matter differentiation is present. There is no obvious extension of the presumed pituitary macro-adenoma into the sphenoid sinus although there is bowing of the left sphenoid sinus roof.
The intra- and suprasellar mass displays imaging characteristics compatible with suprasellar extension and suspected early left cavernous sinus invasion.
Axial whole brain FLAIR, SFOV, coronal and saggital T1 pre- and post-gadolinium, coronal and saggital T2 SFOV.
I now have to take my scans to the neurosurgeon that will do the surgery. Our neuro's is on holiday and will only be back next week. I am thinking of going to the neuro surgeon in Cape Town. Dr P Semple. His speciality is Pituitary Surgery.
What are yourr thoughts on the above. Also the part about the "single spot of white mass of dubious significance" I am unsure about. What do you think the radiologist meant with that part. The specialist said its nothing to worry about.
So have seen the neuro now. He is oldish, think he is close to retirement. Told me he has done many of this type of surgeries before. He will be doing microscopic transphenoidel surgery to remove the tumor. He said there is a chance he might not get everything out. So I will probably have to go for another MRI afterwards.
The surgery is scheduled for the 21st of this month (April). I am booked for 8 days in hospital for the following procedures.
1. Hypo sectors or excision of pituitary tumor, transnasal or transept all approach, non stereotactic.
2. Bone graft
3. Excision or destruction(e.g.laser) intra nasal lesion; external approach( lateral rhinotomy)
4. Craniofacial approach to anterior cranialfossa, extramural, including lateral rhinotomy, ethmoid tony, spenoidectomy, without maxillectomy or orbital exenteration
5. Creation of shunt, ventricular-peritoneal -pleural, other terminus.
What's does all this mean in layman terms?
I am at home now, the surgery was successful. Spent 5 days in ICU and 1 day in the surgical wards.
My follow up with the doc is this Tuesday.
I have problem with breathing as my nose is blocked, lots of dried blood. Not sure if I can use saline drops and gauze to remove some of the dried blood. The doc did say I should leave it. Problem is breathing through my mouth leaves it dry during the night.