Pituitary adenoma

33 years old male with pituatry adenoma . suggest further treatment conservative or surgical

(Edited)
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What was the complaint for which the patient presented with.. The preferred evaluation would be 1)visual field assessment as the most common and early sign in these tumors would be visual field defects. 2) complete hormone profile including anterior and posterior pituitary hormones If both are normal then you can actually wait on these tumors considering to be incidentalomas with serial follow up scans. But considering the size of lesion, it could have signs. The sheer size of lesion can allow it to be considered for surgery ( unless it is a prolactinoma which can be conveniently managed medically). One thing that cannot be ignored is the serum sodium in the report. For a value of 110 I will be surprised if the patient is absolutely asymptomatic. Recheck serum sodium. If it is still abnormal with no other causes to attribute then that itself may indicate that the lesion is significant and needs surgical attention after necessary evaluation
Thank you doctor
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Pt clinical picture is important in this case. What was the reason for doing MRI brain? Normal prolactin ,report mentioned Macroadenoma with mass effect,encasement rt ICA,mass effect on chiasma and Cav sinus. Ref to neurosurgeon for surgery
Thank you doctor
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Conservative therapy never dissolves the tumor.. surgery is required eventually ...So it is better to operate early..Safer, smaller operation, less morbidity, better Nd long lasting outcome
Consult NEUROSURGEON as well as endocrinologist as expert opinion
Thank you doctor
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Agreed with Dr.Rakesh O

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