PITUITARY MACROADENOMA

[SHENAAZ]

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.

[SHENAAZ]

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

[SHENAAZ]

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.

[rumpled]

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.

[SHENAAZ]

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.

[rumpled]

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?

[SHENAAZ]

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.