• A middle-age male had a road traffic accident while riding a scooter. A CT scan was done which located a large Suprasellar lesion. An MRI followed this which showed a large extensive Pituitary lesion. Does this need immediate surgery ?

  • The answer is NO. The prolactin value was done which was 6778 ng/ml which is VERY high. This is what is known as a GIANT PROLACTINOMA

  • Such pituitary tumorss literally melt away using a simple medication and do not require surgery. However, close follow-up of such patients is required.

  • It is imperative to consult an Endocrinologist for any pituitary tumor before any pituitary surgery is contemplated.

Important context

This case describes a prolactinoma, a usually non-cancerous tumour of the pituitary gland. Medicines can lower prolactin and shrink many prolactinomas, but this does not apply to every pituitary tumour or other brain tumour. Treatment depends on the diagnosis, tumour size, symptoms, response to medicines and the person’s preferences. Surgery may be appropriate or necessary in some cases, and can be an initial option for selected prolactinomas. This individual case does not predict another person’s outcome. Decisions about medicines, surgery and follow-up should be made with the treating specialist.

Further reading:

Pituitary Society international consensus statement (2023): https://www.nature.com/articles/s41574-023-00886-5

NIDDK: Prolactinoma: https://www.niddk.nih.gov/health-information/endocrine-diseases/prolactinoma