Recurrence of pituitary adenoma with encasement of ICA

[ShellyM09]

Hello. I hope someone has had experience with this type of recurrence. Transsphenoidal pituitary surgery early 90's to remove large adenoma with f/u radiation. There was residual tumor in the sinus cavities, hence the radiation.
Just diagnosed again, this time with suprasellar extension, extension into planum spenoidale, encasement of the internal carotid artery, and mild compression of the left optic nerve.

Is transsphenoidal resection still an option? If not, what are the options? Also, since further radiation is out, what about photodynamic therapy? Is the prognosis poor this time around?

Thanks so much in advance for any advice.

[rumpled]

What kind of tumor do you have? In other words, what kind of hormone is it secreting or is it a non-secreting tumor?

I had my Cushing's tumor grow back right away while my second tumor, the prolactinoma, so far has stayed gone.

Surgery may be an option but it depends, well, on the condition of your tissues - whether or not you are a candidate. You also want to get a super experienced surgeon as they will keep your carotid safe as you do not want that nicked as well as the same for the optic nerve.

Was your tumor aggressive - or was monitoring late to let it grow so large again?

Have you seen a neuro-opthomologist as well?

[ShellyM09]

Thanks for answering. It's a non-secreting tumor, that was extremely slow growing and has taken well over a decade to return.

I agree about the surgeon, but it's terribly difficult to find that super experienced surgeon.

Do you know of a national support group where it's more likely to find this information>

[rumpled]

I live on the east coast, did research and went to the west coast. No one tells you that you cannot travel! It is not that difficult - make copies of the cds, reports, a few tests and mail that packet around and talk to them on the phone - some will do it for free, some will charge a nominal fee, but this is your health and nothing to mess with.

Given your  history, I would talk to a few surgeons before picking.