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What Does My MRI Scan Indicate?
Hi Doctor,
I am 58 yrs old man. I was having eeling of head and tremor (left side). CT Scan Brain Plain identified with pituitary adenoma on 10th April. It measured 2.0cm x 2.0cm in size. The MRI on 11th April revealed a Pituitary Macroadenoma. I underwent an operation on 3rd May, trans nasal trans-sphenoidal excision of pituitary tumor. I went through an MRI again on 19th September, and it reveled residual Pituitary Macroadenoma measuring 16 mm in AP, 14 mm in trans and 20mm in size in the sella suprasellar region and it mildly impinges the Optic Chiasm. I have been consulting several doctors till now and have been given varied suggestions – reoperation, takes SRT, take IMRT, take Gamma rays. I am thoroughly confused and looking to your expert opinion on the way forward. Can you please suggest what I should do – should I reoperate or take radiation? Is this a cancer or life threatening? Does radiation impair your vision and is it true you need to take it continuously once you started to take radiation? I will be highly obliged if you can provide your feedback on above. Please let me know in case you need any other information.
I am 58 yrs old man. I was having eeling of head and tremor (left side). CT Scan Brain Plain identified with pituitary adenoma on 10th April. It measured 2.0cm x 2.0cm in size. The MRI on 11th April revealed a Pituitary Macroadenoma. I underwent an operation on 3rd May, trans nasal trans-sphenoidal excision of pituitary tumor. I went through an MRI again on 19th September, and it reveled residual Pituitary Macroadenoma measuring 16 mm in AP, 14 mm in trans and 20mm in size in the sella suprasellar region and it mildly impinges the Optic Chiasm. I have been consulting several doctors till now and have been given varied suggestions – reoperation, takes SRT, take IMRT, take Gamma rays. I am thoroughly confused and looking to your expert opinion on the way forward. Can you please suggest what I should do – should I reoperate or take radiation? Is this a cancer or life threatening? Does radiation impair your vision and is it true you need to take it continuously once you started to take radiation? I will be highly obliged if you can provide your feedback on above. Please let me know in case you need any other information.
Thu, 6 Nov 2014
Hi,
Thanks for writing in.
When we are discussing options to treat a pituitary macroadenoma, trans sphenoidal surgery is among the best surgical techniques. Stereotactic radio theraphy SRT and IMRT are also good if there is a well defined space between the tumor and surrounding structures and side effects are minimised. In gamma knife, 12 Gy prescribed dose used in this study seems to be sufficient for producing tumor control while sparing the patient from radiation-induced pituitary dysfunction. In addition, visual improvement was reported in a number of cases.
I recommend you a gamma knife treatment considering side effects and preservation of vision and if done in a place where facility exists and large number of patients are treated with this procedure.
Thanks for writing in.
When we are discussing options to treat a pituitary macroadenoma, trans sphenoidal surgery is among the best surgical techniques. Stereotactic radio theraphy SRT and IMRT are also good if there is a well defined space between the tumor and surrounding structures and side effects are minimised. In gamma knife, 12 Gy prescribed dose used in this study seems to be sufficient for producing tumor control while sparing the patient from radiation-induced pituitary dysfunction. In addition, visual improvement was reported in a number of cases.
I recommend you a gamma knife treatment considering side effects and preservation of vision and if done in a place where facility exists and large number of patients are treated with this procedure.
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