pituitary tumor

1. Does recurrence of a pituitary tumor imply malignancy?
2. What are the ways of treating recurrent tumors surgery or radiation or both?
3. What is proton beam radiosurgery?
4. Are pituitary tumors invariably benign?
5. He was doing thyroxine and other endocrine tests which were normal.
6. Suggest best place for neuro surgery.
please help!!

[Dr Sharma]

Hi there.  Most pituitary tumors are non cancerous or benign and do not spread to other areas of the body. These do not usually cause symptoms unless they grow in size and cause pressure symptoms. it is good that there is no hormonal imbalance.
Recurrent pituitary tumors require very careful study to determine the proper therapy. These can be almost well treated but the management of recurrent cushing’s disease in which total control cannot be obtained by simply re operation alone. Proton beam radiosurgery for recurrent pituitary adenomas is probably the best form of therapy for those patients who qualify for this treatment. A proton beam by contrast to the conventional radiation can be precisely targeted to deposit its energy with pin point accuracy. Treatment is shaped and sculpted to the contours of the tumor.
Recurrent tumors can be treated with radiation terapy and a clinical trial of stereotactic radiation surgery. Radiation therapy is a cancer treatment that uses high energy xrays or other types of radiation to kill cancer cells or keep them from growth. External radiation therapy uses a machine outside the body to sendradiation towards the cancer, internal therapy uses s radioactive substance sealed in needles, seeds,wires etc placed directly into or near the cancer.
Stereotactic radiation surgery uses rigid head frame attached to the skull to aim a single large dose of radiation directly to a tumor causing less damage to the nearby healthy tissue.
You need to visit the neurosurgeon in your primary hospital where they will assess you and refer you to a suitable centre if required accordingly.