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What are the chances of petuitary gland tumours?

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General & Family Physician
Practicing since : 2008
Answered : 3622 Questions
Hello Doctor, I was having mild headaches since last few months. However as soon as I took a cup of coffee the headaches were gone. The headaches occurred sometimes on the left forehead (above the eye) and sometimes on the right forehead (above the eye) and sometimes in the back of the head (left or right). The GP whom I met advised me to go for an MRI even though he suggested that these are just tension headaches. I went for a contrast MRI and Venogram. I am attaching the scanned copy of the report along with this query. I met a neuro surgeon after the MRI report and he told that I have a Pituitary MacroAdenoma. He asked me to undergo a few blood and eye tests. I am attaching all the blood & eye test reports reports as well. The eye surgeon suggested that my vision has not been impacted by the adenoma as parameter results are completely in the safe zone. Even though she informed me that my vision power has increased marginally by 0.5 in both the eyes but that cannot happen because of the adenoma touching the eye nerves. The NeuroSurgeon then advised me that a surgery is required to remove the adenoma even though all my blood tests are normal. My questions are - 1. Even though I have been told that the petuitary gland tumours are rarely cancerous. However, If 1%, it is cancerous, would it be discovered by the MRI? Because the MRI report I sent, is non suggestive of any cancerous growth. I am worried if it is cancerous then it would require a different line of treatment. Are there any physical indicators of such a cancer that I can check with my neuro-surgeon before the surgery? 2. From my research on the internet, I concluded that the adenoma could be non-functional which have little impact on vision or functioning of any glands. So could this adenoma be cured with medicines. Can we avoid the surgery? 3. If a surgery is required, my doctor suggested that it would be non-invasive endoscopic through the nose, how complicated is this surgery? What is the duration of this surgery? Is this surgery long and hard? Can it be done using local anesthesia? Is this surgery common nowadays? Thanks & Best Regards, XXXX
Posted Wed, 5 Mar 2014 in General Health
Answered by Dr. Raju A.T 30 hours later
Brief Answer: Answers are below Detailed Answer: Hi, Thanks for your query. Sorry for the delay in my response. I am medical doctor, an associate in Department of Neurology, working with an experienced Neuroendocrinologist. I answer on his behalf. Answers to your queries are as below : 1)Yes, Pitutary tumors are rarely cancerous as you say. MRI can only identify the gross appearance of the tumor which does not help to rule out malignancy. Yes, if it was a cancer you would have many physical indicators including weight loss and symptoms of metastasis. 2) No, In your case the prolactin is raised. It indicates that the tumor can be a Prolactinoma. No medications would help here. Surgery is a definitive management which good success rate. 3) Endoscopic Transnasal-Transsphenoidal Adenoma resection is a newer technique with good success rate. Also its minimally invasive. The exact duration of the surgery depends on the neurosurgeon operating. Surgery is less complicated as it approaches the tumor with damaging less structures. No it cannot be done under local anesthesia. yes, it is a common procedure with good success. Wish you good health. Regards,
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Follow-up: What are the chances of petuitary gland tumours? 2 days later
Thanks for the response doctor. I really appreciate it. Could you please suggest the best Neuro Surgeon in India from whom I can get this surgery done? I would really appreciate a couple of suggestions. Warm Regards, XXXX
Answered by Dr. Raju A.T 9 hours later
Brief Answer: Please provide your locality Detailed Answer: Hi, Thanks for writing back. Please do provide the city you reside in. I shall advice you one amongst in yor city. Regards,
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Follow-up: What are the chances of petuitary gland tumours? 8 hours later
Thanks for the note doctor. I do not have any city preference. I just want to know the best neuro surgeon who would have the experience of maximum endoscopic transnasal pituitary surgeries in India. Alternatively, my preferred city is Delhi NCR. AIIMS would be an exception. As getting a surgical appointment in AIIMS is an impossible task. You could give me your suggestions in this order - 1. Best Neuro Surgeon in India with maximum experience in endoscopic surgeries 2. Best Neuro Surgeon in Delhi NCR with maximum experience in endoscopic surgeries Moreover, I would like to clarify a couple of other things - You told me that my condition appears to be Prolactinoma. I have been going through a lot of articles on Pituitary disorders. It seems to be that only Prolactinoma tumors could be cured through medications. Please find inline a few links I managed to find - WWW.WWWW.WW uk/information/pituitary-conditions/prolactinoma/ WWW.WWWW.WW In case you feel this does not appear to be a Prolactinoma tumor, do you think this tumor could be non-functional and would still require surgical removal? Thanks & BR, XXXX
Answered by Dr. Raju A.T 32 hours later
Brief Answer: Below are the details Detailed Answer: Hi, Thanks for writing back. The best in India would be Dr XXXXXXX K XXXXXXX is a consultant neurosurgeon at Apollo hospitals, Bangalore. He has experience in endoscope assisted surgery & computer navigated surgery. APOLLO HOSPITALS BANGALORE 154/11, Opp IIM, Bannerghatta Road Bangalore - 560076 (India) Tel.: +(91)-80-0000 / 0000 Amongst Delhi based surgeons I would recommend Dr XXXXXXX S WWW.WWWW.WW Prolactinoma was my differential diagnosis. yes, you are right in saying most of them can be medically treated only if they are functional. If they are causing pressure effects then the best treatment is excision. regards,
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