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Recent diagnosis of non-functioning pit. macroadenoma-help deciphering MRI

While trying to figure out why I have been having chronic ear/sinus infections, it was discovered that I have a pit tumor (helps explains a lot of health issues I've been having for many years now, i.e., glad I renewed my efforts to get to the bottom of things - and no, it's not all in my head (no pun intended), but there really is a medical explanation).

I also have low thyroid function and have been medicated for about 10 years for that.

Since diagnosis I have been reading everything I can on pit tumors, and have found the most helpful to be all the related posts on this site.  I especially like all of the informative rumpled and horselp responses.

I see the neurosurgeon next week.  I imagine he will be recommending surgery and I would think at this size that I want this out of my head.

From reading the MRI findings and what I have read the surgeon will not be able to remove all of the tumor based on the fact that there is partial encasement of the cavernous segment of the right internal carotid artery - does that sound correct?  Any further opinion on the interepretation of the MRI findings would be greatly appreciated.  Thanks in advance!

EXAMINATION: MRI OF THE BRAIN
INDICATION: Abnormal finding on CT of the temporal bones.
Irregularity along the floor of the sella.

COMPARISON: CT temporal lobe

TECHNIQUE: Pre- and postcontrast, multiplanar, multisequence MR
imaging of the brain was performed with dedicated imaging through the
sella turcica. Magnevist, 10 cc, were administered intravenously.

FINDINGS: Diffusion-weighted images demonstrate no evidence for
recent infarction. There are scattered areas of signal abnormality
within the white matter, nonspecific in nature, possibly secondary to
chronic microvascular ischemic changes. There is a moderate area of
signal abnormality identified within the pons, as demonstrated on
images 8 and 9 of series 6. No definite abnormal enhancement is
identified within the pons in the region of the signal abnormality.
The optic chiasm is unremarkable. There
is deviation of the pituitary stalk slightly towards the left. There
is a lobulated appearance to the pituitary gland, which overall
measures approximately 1.6 cm in AP dimension x at least 1 cm in
craniocaudad dimension x 1.6 cm in transverse width. A nodular
component appears to be extending along the sphenoid sinus septum.
There is a nodular appearance along the dome of the pituitary gland
with somewhat of the convex appearance. These findings suggest the
presence of a probable pituitary adenoma. As demonstrated on image 9
of series 12, there is partial encasement of the cavernous segment of
the right internal carotid artery. The internal carotid artery flow
voids do not appear narrowed. No other evidence for abnormal
intracranial enhancement is seen.
There is partial mastoid air cell effusion.

IMPRESSION:
1. Lobulated mass involving the pituitary gland
that extends along the sphenoid sinus septum and into the right
cavernous sinus, likely representing a pituitary adenoma. The
pituitary stalk is deviated towards the left. No significant mass
effect is seen upon the optic chiasm.
2. Extensive white matter changes, including involving the pons.
3 Responses
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Avatar universal
Hope the doc was helpful and you get good news!

Stay in touch. Hope you have an easy surgery (mine was a nice easy one!) it is just the hormonal balancing after that sometimes can take a while... so a good neuro endo on your side is very helpful. Things change over time.
Helpful - 0
Avatar universal
Thanks for your input rumpled.  It is appreciated very much.  I understand that you are not a doctor, but your knowledge is so much greater than mine.  I have so much to learn and have been obsessed with learning more since my diagnosis. I'm going to the neurosurgeon armed with many recommended questions that I saw you mention to others to be sure and talk with the Dr. about.  Short of an M.D. on here right now, to me you are a godsend - our go to girl - thanks again - I may be seeking more of your advice in the coming days/months/years.   Take care.  Will be in touch.
Helpful - 0
Avatar universal
The parts of the pit tumor in the cavernous sinus are inoperable. Stuff wrapped about tender areas like nerves and veins and arteries can be snipped about, but can leave a few cells here and there, so you will likely have to have radiation.

Look into the types, and risk/benefit of each.

The white matter changes are something else - and can represent another disorder entirely IMHO - not a doc...
Helpful - 0
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