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Pituitary Adenoma
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Pituitary Adenoma

Three weeks ago, my daughter, aged 17 years, was  found to have Pituitary Adenoma( on CT and MRI), of size .8 x 1 cm, located within the confines of sella Turcica. It is said to be non-functional but due to its pressure effects, the pituitary is not secreting enough ACTH with resultant low adrenal steroids. This low level of hormone caused her blood sugar level to drop at dangerously low levels, making her unconcious once, for which she was taken to the emergency. She is given hydrocortisone 15 mg + 10 mg/ day. Her blood sugar remained normal after that. Her eye fields are normal.
During her stay at hospital she remained drowsy most of the time and it was very difficult for us to arouse her from sleep. On sleep EEG, some abnormal activity was found in the right Temporal region which was thought to explain her difficult arousal. She gave some history of Deja-Vu, a few times occurence, so Petit Mal was considered responsible. She is given Tegretol 200 mg once a day. So long this therapy has not improved her arousal from sleep. Is Tegretol suitable for her ?
For adenoma we are given 2 options to choose from, either to go for surgery( Trans- sphenoidal or through skull) or stereotactic focussed beam radiotherapy. We are scared about surgery at this age. What do you suggest we should opt for and when?
Can we wait and keep on monitoring the size of adenoma?
Her drowsyness now could be side effect of her medication, how it could be eliminated or minimised? Initially Oxycrbamazepine was given which caused her nausea so it was replaced with Tegretol. Her appetite is still very poor. She is weak and lethargic. Her studies are disturbed.
Your suggestions will mean a lot to us ?

A mother ( scared to she is my only daughter)
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368886 tn?1466238884

I feel sorry for your daughter's condition.

Yes, Tegretol is suitable, as the doctors suspect partial epilepsy, originating from the temporal lobe. It may affect the sleep though.

The decision of surgery has to be taken by a consensus of you and your doctor. The symptoms are only going to increase, as it is a tumor.

The drowsiness could be taken care of by adjusting the doses of the drugs, or replacing them with other drugs possibly of the same class.

If this is a Prolactinoma, cabergoline (Dostinex, Cabaser) may be given which in fact reduces the size of the tumor. But, the results of radiation and surgery are good.

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