Aa
PITUITARY MACROADENOMA
Hi, my husband recently found out that the approx. size of the enhancing mass was 2.2cm in longitudinal extent, 1.9cm AP and approx. 1.6cm in transverse diameter. The mass extended superiorly into the suprasellar cistern and was slightly lobulated in appearance at its superior surfance. The pituatary stalk itself could not be demonstrated on the sequences and the cavernous sinuses were well demonstrated with normal appearances and without involvement with the cavernous sinus. The scans through the pituatary gland region does reveal the mass positioned within the pituatary fossa which was intermediate signal intensity on the T1 study, high signal intensity on the T2 study and did enhance fairly intensely with contrast medium on the post Gadolinium studies. The internal carotid artery was well demonstrated within the cavernous sinuses. Pse. explain how big is this tumour. What is the best treatment option. Regards, SHENAAZ
This discussion is related to Acromegaly My MRI results Please tell me what you think.
This discussion is related to Acromegaly My MRI results Please tell me what you think.
I have been ill, something lung so not been around as much. Glad to hear your husband is doing well!
Hope you keeping well. My husband had an MRI done and thank god there is no sign of any pituitary tumors. Regards.
Hi. Dr Zaheer Bhayat on 011 042 8280. He is based in Bedfordview, near Eastgate, Johannesburg, Gauteng. If you don't mind, please inform both Prof. Gopal and Dr Bhayat that I referred you to them. Good Luck and REgards.
Hello Shenaaz
Could you please advise on a very good endocrinologist in Johannesburg, I have booked an appointment with Prof Gopal, but I'd also like to see an endocrinologist while I'm in South Africa.
Thanks for helping
Could you please advise on a very good endocrinologist in Johannesburg, I have booked an appointment with Prof Gopal, but I'd also like to see an endocrinologist while I'm in South Africa.
Thanks for helping
Good! The expert here is also helpful but you did not give him much information in the post IMHO...
Thanks for your reply. I have also emailed the Brain Tumor Centre and Pituary Disorders Program at Saint John's, Santa Monia, CA, for an opinion. Regards.
Skull base tumors may, or may not, but operated by skull base surgeons who have different tools and skills to remove them so I would consult one of them as a second opinion.
As for radiation, the deeper the tumor, the more healthy tissue is effected. In some cases, the head can be turned so that the tumor can be accessed so that few vital things are hit. The issues are radiation leakage - even though it is a beam, some of the beam can and from what I understand (my research was a while ago) make the area hit slightly wider - we are talking tiny amounts but if the tumor is near a vital blood vessel or nerve, this may be an issue. So you want an experienced center, and even though say, gamma is easy since it is one visit, perhaps one larger dose may not be the right course as smaller, more precise dosing. So I would question his neurologist about the types, the benefits that work FOR HIS TYPE OF TUMOR given that we don't know his type, and how long it will take to work, also the size and how extensive the radiation and if it will be a combo of surgery of radiation etc.
As for radiation, the deeper the tumor, the more healthy tissue is effected. In some cases, the head can be turned so that the tumor can be accessed so that few vital things are hit. The issues are radiation leakage - even though it is a beam, some of the beam can and from what I understand (my research was a while ago) make the area hit slightly wider - we are talking tiny amounts but if the tumor is near a vital blood vessel or nerve, this may be an issue. So you want an experienced center, and even though say, gamma is easy since it is one visit, perhaps one larger dose may not be the right course as smaller, more precise dosing. So I would question his neurologist about the types, the benefits that work FOR HIS TYPE OF TUMOR given that we don't know his type, and how long it will take to work, also the size and how extensive the radiation and if it will be a combo of surgery of radiation etc.
Hi. When speak to my husband's newphew he informed me that his tumor is situated on the base of the brain. This looks like a skull base tumor which according to research quite difficult to treat. According to research his best option is radiation, but again the big question which one. Thanks.
I am not that experienced with menigiomas. So I am not that helpful in specifics - I know more about pituitary as that is what I had.
Most questions come from knowing the type, the aggressiveness, and what the normal treatment protocol is and if the doctor thinks that will work or does he suggest changes and why.
I wish I could be more helpful.
Most questions come from knowing the type, the aggressiveness, and what the normal treatment protocol is and if the doctor thinks that will work or does he suggest changes and why.
I wish I could be more helpful.
Hi, I have asked my husband's nephew to see the Neurosurgeon. Can you assist me with questions to ask the Neuro before he decides what treatment plan to take. Thanks
Hi. I don't know if my husband's newphew knows what type of meningioma he has. From the X-Ray report can you establish what type of meningioma it is. From my research there are are quite a few types of meningiomas and different treatment plan. Thanks.
I am sorry I cannot answer that question about the cause of the seizures.
Gamma is the oldest form of radiation. It is one shot, so convenient. Cyber knife takes multiple treatments, from what I researched is slightly more accurately (this is all tiny tiny amounts but that can make a difference depending on the location). Proton beam is the newest and does not effect the tissue it passes through so it is the best as far as long term side effects, but is expensive and there are few centers around (in the US).
There are other things too but those are the ones I researched. You have to research as not every type is used in every case, and also ask about radiation leakage, necrosis odds in the long term and the fall back question what would you want if it was your family member.
Gamma is the oldest form of radiation. It is one shot, so convenient. Cyber knife takes multiple treatments, from what I researched is slightly more accurately (this is all tiny tiny amounts but that can make a difference depending on the location). Proton beam is the newest and does not effect the tissue it passes through so it is the best as far as long term side effects, but is expensive and there are few centers around (in the US).
There are other things too but those are the ones I researched. You have to research as not every type is used in every case, and also ask about radiation leakage, necrosis odds in the long term and the fall back question what would you want if it was your family member.
Thanks for the advice. He has everyone around him to advocate him. Is the scarring or the tumour causing the seizures? If he chooses radiation which one is the good one with minimal side effects.
I would have no idea not being a doctor - but I would ask about it considering that he has symptoms and scar tissue. It may be that since he has scarring, he may only have the option of radiation.
He may also be on meds like steroids that can cause mood swings. I hope that he can find a medication to control the seizures or some other way. Are his parents advocating for him? Or is he old enough that he and his wife, if any, are doing this?
He may also be on meds like steroids that can cause mood swings. I hope that he can find a medication to control the seizures or some other way. Are his parents advocating for him? Or is he old enough that he and his wife, if any, are doing this?
He gets seizures and mood swings. I also needed to know more about endoscopic meningioma surgery. Is it possible in his case. Thanks once again.
I'm not a doc - so all I can say is that it has grown a little and he has scar tissue forming (gliosis). We had a person posting before with a meningioma that kept growing back and I don't know if she lurks around anymore but she had to have a couple of surgeries and finally radiation.
It does not seem to be growing super fast though - in two years in has only been not even half a cm on one side - but still you would rather it not grow at all.
Is he having mass effect or other side effects from it? They may want to leave well enough alone until they have to do something?
It does not seem to be growing super fast though - in two years in has only been not even half a cm on one side - but still you would rather it not grow at all.
Is he having mass effect or other side effects from it? They may want to leave well enough alone until they have to do something?
Hi. The MRI taken recently reads as follows: The current scans demonstrate evidence of the previous surgery at the left temporal fossa and some gliosis and volume loss in that area. The residual dural-based brightly enhancing mass is noted as before in the left upper temporal region. Features are consistent with a meniongioma. Direct AP and side to side dimensions on the axial view are 2.62cm and 2.71cm and this is identical when using the same measurement technique on the previous scans. On coronal imaging the current dimensions are 2.94cm x 3.12cm, i.e. 2.94cm side to side and 3.12cm vertically on coronal post-contrast image no. 3. On the previous scan the maximum dimensions in the coronal plane were 2.47cm x 2.33cm. No other abnormalities are seen. Conclusion: The evince of previous surger is noted again at the left temporal fossa and the residual brightly enhancing tumour, consistent with a residual portion of meningioma. On the current post-contrast axial imaging, the dimensions are identical to those of the previous scan of Sep. 2012. On current coronal post-contrast imaging there does seem to be a fractional increase in size when compared with the previous scan. Please let me have your comments. Regards.
Hi. Thanks went on to the internet and found video of skull base surgery. Very interesting. Will look for skull base surgeon in South Africa. Regards.
Thanks for your reply. His tumor is sitting on the left hand side of the brain. Why partial removal was done is also now known and also why radiation was not suggested is also not known. Anyway I will try and get more info from him. Thanks once again.
I am not a doctor, but I only know of anti-seizure meds but I don't know of any meds that shrink a meningioma.
Sometimes anatomy prevents removal - so it could be where the tumor sits that prevents total removal. Did he or his family get the reports so they know the before and after and get an explanation as to why it was a partial removal? In this case they may do radiation to shrink or kill the tumor. Again, depending on the location of the tumor, the risks can vary. Has that been discussed with him and his family?
There are also skull base surgeons who can use smaller instruments IF the lesion is operable - there are just so many factors here and little information. I hope he is getting other opinions, as well as getting his own records to know what is going on in his own body.
Sometimes anatomy prevents removal - so it could be where the tumor sits that prevents total removal. Did he or his family get the reports so they know the before and after and get an explanation as to why it was a partial removal? In this case they may do radiation to shrink or kill the tumor. Again, depending on the location of the tumor, the risks can vary. Has that been discussed with him and his family?
There are also skull base surgeons who can use smaller instruments IF the lesion is operable - there are just so many factors here and little information. I hope he is getting other opinions, as well as getting his own records to know what is going on in his own body.
Have an Answer?
You are reading content posted in the Brain/Pituitary Tumors Community
Here are 15 ways to help prevent lung cancer.
New cervical cancer screening guidelines change when and how women should be tested for the disease.
They got it all wrong: Why the PSA test is imperative for saving lives from prostate cancer
Everything you wanted to know about colonoscopy but were afraid to ask
A quick primer on the different ways breast cancer can be treated.
Get the facts about this disease that affects more than 240,000 men each year.
