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pituitary macroadenoma

.. please help to enlighten us about this illness - how to treat it and where is the inexpensive hospital for the surgery, thanks po ..


  • LesLes PEx Veteran ⭐⭐
    A pituitary macroadenoma is a tumor growing within the pituitary gland. The pituitary gland is found deep inside the brain and is often called the "master gland" because it secretes hormones that controls different endocrine functions like production of sex hormones, thyroid hormones, etc. A "macroadenoma" means it's at least 1 cm in size, if it's any smaller than that it's called a "microadenoma."

    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.
  • ^ thank you for the quick reply, much appreciated, since we didn't know any endocrinologist, my sister who has macroadenoma visited a neurologist today and advise her to have hormonal study, a blood test, i guess to know if her tumor is prolactinum, in which she can avoid surgery ..
  • LesLes PEx Veteran ⭐⭐
    I suggest you find a endocrinologist since I doubt neurologists are familiar with entire spectrum of hormonal disturbances that can occur with pituitary macroadenomas. Prolactinomas can often be diagnosed because of elevated prolactin, but not all prolactin elevations mean the mass is a prolactinoma. For example, many growth hormone-secreting tumors also secrete prolactin, and a mass that doesn't secrete any hormones (nonfunctioning) can also elevate prolactin if it compresses the stalk of the pituitary gland.

    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.
  • i had a case of pituitary macroadenoma.. naoperahan ako last april of this year lang. hyperprolactemia ang case ko. elevated ang prolactin.
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