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What Does This MRI Showing Pituitary Adenoma Indicate?
Question: HI Doctor,
I recently inquired about a pituitary adenoma. I attached an MRI result of the size and my blood work. Is there anything that you may need to help me decide whether I am currently unable to have kids? I have not really had a period in almost 5 years...what worries me the most is that I have constant headaches, I've gained weight, I have very high anxiety and I'm very moody like a pregnant woman would be. According to the MRI Results, my macro adenoma is at 1.84 cm large, and I can already tell that my eyesight is not the greatest I just turned 26 years old and would like to know how long it would take for me to be able to have kids.
Thank you again
Thank you again.
I recently inquired about a pituitary adenoma. I attached an MRI result of the size and my blood work. Is there anything that you may need to help me decide whether I am currently unable to have kids? I have not really had a period in almost 5 years...what worries me the most is that I have constant headaches, I've gained weight, I have very high anxiety and I'm very moody like a pregnant woman would be. According to the MRI Results, my macro adenoma is at 1.84 cm large, and I can already tell that my eyesight is not the greatest I just turned 26 years old and would like to know how long it would take for me to be able to have kids.
Thank you again
Thank you again.
Brief Answer:
Macroprolactinomas and fertility
Detailed Answer:
Hello,
Extremely sorry for the delay in reply. I am travelling and don't have Internet access always.
The images didn't have pituitary specific cuts. I realise that you are off treatment now . Once the treatment starts, there is a high chance of tumour shrinkage. You have to get your eyes checked as soon as possible and that too decides the waY of treatment. Most prolactinomas shrink with medicine (cabergoline) and periods and fertility returns. However if there is insufficient shrinkage of tumour size despite being on treatment or if there is a major threat to vision , then you may need surgery.
The problem is that, we have to preserve your FSH and LH secreting pituitary cells for fertility. Surgery may occasionally destroy them too . and in your case the best option would be medical treatment with cabergoline if no contraindications. You have to do an IGF 1 and certain genetic tests as well.
This require a team approach between endocrinologist, radiotherapist, neurosurgeon and infertility specialist. A multidisciplinary meeting is often required when dealing with such a situation and the best decision would come out of such a meeting.
Fertility in prolactinomas is very much possible with treatment . But the risk of increase in pituitary adenoma size during pregnancy is a concern. Not to worry. Your treating doctors will come out with a most suitable option for you.
Regards
Binu
Macroprolactinomas and fertility
Detailed Answer:
Hello,
Extremely sorry for the delay in reply. I am travelling and don't have Internet access always.
The images didn't have pituitary specific cuts. I realise that you are off treatment now . Once the treatment starts, there is a high chance of tumour shrinkage. You have to get your eyes checked as soon as possible and that too decides the waY of treatment. Most prolactinomas shrink with medicine (cabergoline) and periods and fertility returns. However if there is insufficient shrinkage of tumour size despite being on treatment or if there is a major threat to vision , then you may need surgery.
The problem is that, we have to preserve your FSH and LH secreting pituitary cells for fertility. Surgery may occasionally destroy them too . and in your case the best option would be medical treatment with cabergoline if no contraindications. You have to do an IGF 1 and certain genetic tests as well.
This require a team approach between endocrinologist, radiotherapist, neurosurgeon and infertility specialist. A multidisciplinary meeting is often required when dealing with such a situation and the best decision would come out of such a meeting.
Fertility in prolactinomas is very much possible with treatment . But the risk of increase in pituitary adenoma size during pregnancy is a concern. Not to worry. Your treating doctors will come out with a most suitable option for you.
Regards
Binu
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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