Hello doctor, I am 29 years old female. My prolactin levels were found to be 1000 ng/ml. Pituitary size on MRI showed 17 × 26 × 15 mm. The endocrinologist said it is macroadenoma and asked to consult a neurosurgeon. My query is that whether the pituitary size is too big. Can an endocrinologist not treat it with medication? How early I have to take treatment? Is surgery required? I have no headache or blurred vision.
Hi. I understand all your concerns. From what you have mentioned, you have a large prolactinoma which requires treatment. Usually, we start with medication in order to reduce the hormone level as well as the mass size. In those with macroadenoma, surgery is usually required in order to prevent complications like nerve compression that could affect the vision. Please provide me with photocopies of the investigations you have performed and let me know if you have any symptoms. Vision field examination is required. In case of surgery, a transsphenoidal approach is the most common.