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pituitary macroadenoma
kastuyan
PExer
.. please help to enlighten us about this illness - how to treat it and where is the inexpensive hospital for the surgery, thanks po ..
Comments
Essentially all pituitary adenomas are benign, meaning they are not cancerous and do not spread elsewhere in the body (metastasis). Unfortunately, since they are found inside the brain, once it starts growing it compresses structures causing damage to them. Compression of the pituitary gland can lead to a decrease or cessation in hormone production ("hypopituitarism) while extension of the tumor upward compresses the optic chiasm, which contains nerves that carries information from your eyes. This causes loss of vision, often in the upper and outer part of the visual field. If left untreated the growing tumor will squeeze the chiasm and lead to blindness that is often irreversible.
Treatment involves surgical removal of the tumor, unless it's a special kind of tumor called a prolactinoma. Prolactinomas often respond to certain kinds of medications, causing it to shrink, which can avoid the need to do surgery. Other kinds of macroadenomas will need to be removed surgically.
The first step in managing a pituitary macroadenoma is to find an endocrinologist that will manage the case, NOT a brain surgeon. A patient with this kind of tumor needs to have a special workup done to see if the tumor is producing excess hormones or the pituitary is damaged and the patient is lacking them. If these problems are not corrected, surgery cannot be done. Only when these have been evaluated and corrected, if necessary, will it be safe to undergo surgery.
Majority of macroadenomas do not require creating a large opening in the skull that patients usually dread. Rather, the tumor is removed by creating a small hole at the base of the skull, which can be done by instruments that pass through the nostril or by creating an incision near the gums. The tumor is then removed or sucked out through the small opening. Recovery in this procedure is fast and the patient is already awake soon after surgery.
Endocrinologists will refer a patient with a macroadenoma, after evaluation, to a neurosurgeon that they trust. The best outcomes happen when the the surgeon operates on a lot of these tumors instead of just every so often. Therefore you should seek the guidance of an endocrinologist first for proper medical evaluation, and then seek a recommendation for a high-volume neurosurgeon.
Furthermore, some hormone deficiencies, particularly cortisol and thyroid hormone deficiencies are more serious than others and need to be addressed promptly if present. A pituitary mass CANNOT be assessed properly with just a single lab examination for prolactin.