Pituitary Adenoma & MS

Question

This is a question similar to the 'cervical condition' question I posted a few days ago.

After my bout of optic neuritis last April, the ophthalmologist ordered an MRI and that's how they discovered two scarred lesions and confirmed the optic neuritis.  However, my MRI also showed that I had a small pituitary adenoma (microadenoma).  Both the radiologist and my eye doctor coincided that I needed to be checked by an endocrinologist, and my eye doctor told me to see one after going to the Neuro.  As part of the diagnosis protocol, my neuros at the MS Clinic ordered several blood tests, after which they confirmed the optic neuritis as a Clinically Isolated Syndrome with high likelihood of becoming MS (and I started Copaxone right away).  Doctor said Microadenoma was unimportant and said we should keep an eye on it over years.

As a result, I never went to see an endocrinologist.  But I am not sure if this is the right approach.  I trust my Neuro, but I also feel that just as I was seen by an MS specialist to evaluate possible MS, I should go to an endocrinologist to see what exactly this pituitary adenoma is about (especially since I had partial bilateral sight loss as one of my crazy isolated symptoms 10 years ago!).

Let me know what you think about this.  I would love to hear your thoughts!

Pablo

slightlybroken · Answer

From what I read about them, they are typically benign, slow-growing tumors that arise from cells in the pituitary gland, but I know that doesn't make you feel better.

I truly don't think your sight loss 10 years ago was from the pituitary adenoma. Once they get a certain size, there is no turning back. Symptoms would keep occurring, not only vision loss in extreme cases with the large adenomas ( macroadenomas), but you would get other symptoms such as pituitary failure, headache, etc.. which they would have caught on the blood panels & MRIs. A microadenomas is very small and most of the time doesn't cause any symptoms.

But I would still get an endocrinologist on board and have them monitor your case. It's good to have a specialist on board and have them watching this part of you, just in case problems may arise from it. I'm sure your neurologist is capable of doing so as well, but I always take extra comfort when a specialist for the field they practice in is watching my progress. I think it would ease your mind as well.

Take Care

marymoto · Answer

i had a pituitary tumour that was quite small at first and over a couple of years it began to grow into a much larger pituitary tumour then i had it operated on they did the surgery transphenoidal which means they used very small instruments through my nasal passage to access the pituitary tumour. but this took a few years to grow and most are only small microadenomas which are quite common.

anuragsrivastava · Answer

Hi, Thank you for your question. Pituitary adenomas are brain tumors that may remain asymptomatic for long years. But if it is large it can cause headache, vision problems, hormonal imbalance, paralysis, seizures and gait disorders. Therefore, surgical intervention is essential to remove the large adenomas and if permanent damage needs to be avoided. Craniotomy, needle aspiration and cerebral shunts are common surgical treatment that may help. Please consult a neurologist right away in this regard. Hope this helps.