Q:Hi Professor Wei: I would like to consult about my condition. 8 months after my child was weaned, I still had lactation and no menstruation, so I went to the hospital for some tests, ultrasound was good, blood test pituitary prolactin 1322.3 (reference value 59-619), cranial MRI showed full pituitary morphology, mild saddle base subsidence, pituitary stalk to the right side mildly The pituitary stalk was slightly displaced to the right. The pituitary gland is unevenly reinforced after enhancement. I would like to ask if my condition is a pituitary microadenoma. How should I treat it? Reply:This is a very common condition. During pregnancy and breastfeeding, the normal pituitary gland is significantly enlarged, and after weaning, the enlargement gradually returns to normal. However, in some women, the hyperplastic pituitary gland does not recover for a long time and shows lactation, menstrual disorders, mild increase in blood prolactin, and an increase in pituitary volume or limited increase in MRI. Her features are: 1. normal sexual performance; 2. mildly increased PRL with a wide range of fluctuations; 3. no clear tumor visible on MRI. The vast majority of pituitary hyperplasia will return to normal naturally without any treatment. Only a very small number of hyperplastic pituitaries develop into tumors. In our country, many doctors in endocrinology, obstetrics and gynecology, radiology and neurosurgery, whenever they see increased prolactin, lactation and menstrual irregularities, and increased pituitary volume on MRI, they basically diagnose pituitary tumor and recommend medication, surgery or gamma knife treatment. On the other hand, women with these manifestations want the doctor to make a conclusion as soon as possible (if the doctor does not have a conclusion, it is considered that the doctor is not very good), and want to treat their “disease” as soon as possible. As a result, there are random diagnoses and random medications and other treatments. Do you understand your disease? It should be a normal pituitary gland physiological hyperplasia!
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