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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What is your opinion post MRI for high prolactin levels?

hi my sister is 22 years old and she was complaining from high prolactin levels and last time the doctor(gynecologist ) asked her to make MRI (MID OF THE SEIAlA TURCICA) and the result came as follows:
a 22 old female patient with hyperprolactinemia of 6 year duration associated with recent visual field defect no previous similar studies for comparison however the current study reveals a well defined focal lesion is noted at the left aspect of pituitary gland measuring 6 x6 mm in its craniocaudal x transverse diameter displaying delayed enhancement compared to the rest of adjacent normal galndour tissue especially noted in the dynamic phase and delayed postcontrast study with mild downward sagging of the sellar floor and minimal focal bulge of the glandular contour still central pitutary stalk with no signifiganct mass effect .
normal optic charisrnas
normal suprasellar and paraseller sturctures
complementary T2 of the brain is unremarkable .
N.B.
Prominant Nasopharyngeal lymphoid tissue.
Right maxillary antrum retention cyst.
Opinion :
the picture has keeping with pitutary microadenoma implicating the left aspect of adenohypopysis displaying size and imaging features as detailed above
so what you think about the report as the doctor said need surgery or there is any other option
Fri, 25 Apr 2014
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Radiologist 's  Response
Hi,
Thanks for writing in.

The findings are pointing towards a diagnosis of pituitary microadenoma which is a small tumor of pituitary origin and this might be causing the hyperprolactinoma aswell as visual field defect. This needs a detailed discussion with a neurosurgeon and a proper analysis of the type of visual field defect she is having. The tumor is very small and if there is significant pressure effefct due to the tumor, steps may be taken to remove it through a trans sphenoidal approach (through the roof of the nose). If there is no significant pressure effects then the patient may be kept under observation and repeat MRi may be done after 6 months to a year.
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What is your opinion post MRI for high prolactin levels?

Hi, Thanks for writing in. The findings are pointing towards a diagnosis of pituitary microadenoma which is a small tumor of pituitary origin and this might be causing the hyperprolactinoma aswell as visual field defect. This needs a detailed discussion with a neurosurgeon and a proper analysis of the type of visual field defect she is having. The tumor is very small and if there is significant pressure effefct due to the tumor, steps may be taken to remove it through a trans sphenoidal approach (through the roof of the nose). If there is no significant pressure effects then the patient may be kept under observation and repeat MRi may be done after 6 months to a year.