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1448748 tn?1312956208

Just got results from mri, microadenoma what are the treatment options?

I have suspected a pituitary tumor for at least a year but nobody has listened to me.. surprise surprise, but finally I got someone to do an mri of my pituitary and there is a mass there 8mm, but this was done with a normal t2 mri machine, I know these can sometimes even miss micro adenomas... so they told me they are referring me to another endocrinologist, to do ?? they haven't explained much or told me anything about my treatment plans options or what will happen... and I have had a horrible headache for a month now.. I am convinced it is because of the adenoma... but the endocrinologists don't have any openings until september and I am desperate to get rid of this headache.. I am assuming this apt in september will only be an initial consult.. then another apt what another month later to do further testing and then start treating this? I have had awful symptoms and another endocrinologist that kept chalking it all up to the pain meds I was on.. me not producing any of my own cortisol, having low hormones accross the board and kept dismissing my fatigue and irregular and missed menses, and vision problems, and the whole shabang.. said it would all go away once I got off my pain medicine.. which I cannot stop due to various chronic pain and other health issues.  So anyways.. I do not want to go back to him, as any person in their right mind would not right? Or should I and say in your face I was right the whole time and you wouldn't listen?? He told me to just wait until I magically started producing my own cortisol then we would wean me off and that is the only thing he has treated me with is prednisone.

So my other question is.. my nuerosurgeon is the one who ordered the mri because I told him about my symptoms and they found it.. but they haven't told me anything about how they plan to treat it or how serious this is or what I am going to have to do.. I have done some research, but I only know that there are 3 ways to treat... medicine, surgery, and radiation.. but I do not know which treatment is for a microadenoma which is what I have and I do not know if anyone can help answer any of my questions, or how I can be seen sooner or if I am on the right track or not?

Any help and input would be greatly appreciated.  I really need some relief from this awful headache...
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Avatar universal
There are some specialists that will take it. I would hunt around and look - look for a state university center as that may be your best bet.

Ah - so you have a reason for the pred then it makes sense. Just keep on top of it and watch out for side effects.

Do you get copies of your test results? With and without contrast is a normal MRI - dynamic means the contrast is given and images are taken and the uptake of the contrast is recorded. But your tumor is pretty easy to see.

BTW the pituitary issues can contribute to the GI issues.
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1448748 tn?1312956208
I dont know.. My mri was done with and without contrast with views of the sella.... I think it was a T1.5 then...

My problem with going to specialists is that I have medicaid , it is a state provided health insurances, and most people don't take it, but I will look at those health pages, I cannot go out of state with my insurance either.

I take prednisone because I tried hydrocortisone, but I have gastroparesis, and I think that It doesnt process right because of the short halflife.  I don't absorb it right away because my stomach takes 9 hours to empty instead of normal 1-2 hours.. so because of this, I think since the pred. stays in my system longer, I get some benefits, with hydrocortisone, I didn't notice much help in my symptoms at all.
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Avatar universal
I would look around for a NEURO-endo, and not just a regular endo. You need to get in to a pituitary center and try to find one at a larger hospital or university center. There are links in the health pages (look down, maybe to the right - they keep moving) to help you.

The treatment all depends on the type of tumor - and the type can only be discovered after a boatload of testing. If you have low hormones across the board it sounds like you are hypopituitary or panhypopituitary anyway and need to see a neuro-endo to get the replacements. Pred is not the best replacement for cortisol - it has a lot of side effects - it has nice once a day dosing but since it lasts more than one day, you stack doses, and the body does not get to rest to build bone and all... hydrocortisone is the preferred replacement.

BTW you won't magically start making your own hormones - once they are gone, they are gone for the most part. So you need an expert. You also probably need other hormones and assistance to feel better. I am panhypopit - so I know it can be a challenge.

I would go see an eye doc - a neuro-optho as well to make sure all is well.

Re MRI, I don't know T2- I know T1.5 and T3 - but your tumor is large enough to be seen. The proper pituitary protocol is dynamic - was yours done that way?
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