Patient: Description of condition (onset, main symptoms, hospital visited, etc.): Amenorrhea for one year, hormone 6 test results showed PRL > 200ng, with extruded breast overflow. Started regular menstruation, no increase in body hair, slight weight gain, sometimes headache. MRI results: pituitary gland is plump, height 11mm, right flank manifestation is obvious, limited slightly long T1 slightly long T2 signal is seen, posterior pituitary lobe high signal is present, pituitary stalk is shifted to the left. Other signals are normal. Diagnosis and recommendation: abnormal signal of pituitary gland, consider pituitary microadenoma. Previous Chinese herbal treatment has not been effective. Is it a pituitary tumor? And no other possible cause of pituitary hyperplasia? What is the difference between the two? Do I need to have my nail function checked? If so, how many tests should be done?
A: Although I haven’t seen the film, the diagnosis of “pituitary PRL-secreting adenoma” is basically valid based on your description above, and pituitary hyperplasia is actually rare, and the concept is not clear, so most of the time it becomes the subject of academic discussion. Treatment: Transsphenoidal surgery is recommended.
Patient: Thank you for your reply. I still have a few questions, one, why did the MRI not report the size of the tumor? I did a plain scan plus dynamic enhancement. Second, low thyroid function will lead to increased compensatory release of prolactin, will this lead to pituitary enlargement? That is, is it possible for low thyroid function to cause a pituitary tumor?
A: The interactions between pituitary hormones are very complex and cannot be clarified with general understanding, even professional doctors cannot explain it in a few words, if you are not reading medicine, don’t push it. The MR images of microadenomas are so close to “normal” that it is often difficult for the machine to accurately distinguish the location, and sometimes it does not correspond to the location during surgery. We have performed hundreds of microadenoma surgeries and so far there has not been a single case of pathological misdiagnosis.