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  • Question: I am a 32-year-old male and was diagnosed 4 years ago with a non-functioning pituitary adenoma. Originally it was 2 x 3 mm, a year later it was 5 x 5 mm, and 6 months ago it was 6 x 6 x 10 mm macroadenoma. The tumor is asymptomatic, however, I have mild headaches that are focused behind my eyes and mostly feel like sinus pressure. I am also an army national guardsman in the military and currently deployed in Iraq. Last week I had a follow-up MRI at a military hospital in Germany and it was reclassified at 5 x 5 mm, from a different radiologist. My endocrinologist stated that these tumors have a mind of their own and it isn’t abnormal for the sudden change. She also stated that she will get the previous MRI done in the States and have her staff compare them side by side. The peculiar thing is that the readings from the current MRI placed the tumor on the right side of the pituitary and the MRI from 6 months ago said it was on the posterior. I have a copy of my MRI on disk and looked at the results. I am able to see a dark circle on the right side of the pituitary that measures roughly 5 x 5 mm, but on the cross-sectional image, there is also a 8 x 11 mm dark circle which I believe is on the posterior. Is it possible to have two tumors or is it more likely that one of the readings was inaccurate? It was also ruled out 6 months ago for surgery based on the recommendation from an Army neurosurgeon, based on the lack of symptoms. Is there a general rule of thumb for surgery for this type of tumor, or is it based more on location and symptoms?
  • Answer:04/03/2005
    I have not heard often that a tumor which has more than doubled in size should not be treated, or evaluated for surgery. Have you had any leakage/ secretion from your breasts? The mild headaches and sinus pressure sound like symptoms to me. I would suggest evaluation by a civilian neurosurgeon who is an expert in brain tumors (operates on more than 50/year. The Army doctors may not be in that group.

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