New Diagnoised - Tumour Size Query?

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New Diagnoised - Tumour Size Query?

Postby Marc_U » Sat Dec 09, 2017 6:16 pm

Hi,

I have been recently diagnosed with Acromegaly, following a number of tests & MRI scan - am awaiting hospital appointment in early January to find out proposed treatment.

The Clinic report says that I have : " 7x 8mm pituitary micro adenoma om the right side of the pituitary gland"

As I understand that the pituitary gland is a size of pea, this sounds a lot. Would this be classed as small, medium or big tumours?

Can anyone clarify?

Thanks,

Marc
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Re: New Diagnoised - Tumour Size Query?

Postby member_41389 » Sat Dec 09, 2017 9:10 pm

Hi
In answer to your question about sizes:
The pituitary gland is shaped rather like a bulb of garlic but has just two "cloves", roughly the same size, called the anterior (front) and posterior (back) lobes. overall its roughly 10 mm in diameter and a bit less than that high.
The name adenoma simply means a growth on a gland. A pituitary adenoma is micro if less than 10mm across (so roughly smaller than the gland itself) and macro if its bigger than 10mm.
So your ademona is at the high end of micro (small).
The size counts because the bigger it is the more likely it is to effect your vision because the optic nerves (called the optic chiasma for some reason) pass through the base of the skull above the pituitary. So if the tumour grows up or pushes the pituitary up then it can squeeze the optic nerve resulting typically in the loss of peripheral vision (called hemianopia).
A second type impact of the tumour depends on what type of cells it comprises. The majority are called non-functional because they don't effect the function of the pituitary in a significant fashion. As an interesting aside, roughly 1 in 6 people are found to have a pituitary adenoma at post mortem so they are very common.
Other adenomas produce hormones from the anterior pituitary such as; prolactin, the hormone responsible for producing milk, is probably the most common; growth hormone, leading to Acromegaly, ATCH, leading to Cushing's disease, and other less common affecting the sex hormones or thyroid function.
Adenomas or damage relating to the posterior pituitary seem most commonly to relate to the loss of a hormone called vasopressin (also called AVP or Antidiuetic Hormone) which regulates the amount of urine you pass. The loss of this hormone leads to Diabetes Insipidus (misunderstood by 99% of medical professionals who stop listening at Diabetes).
You will find lots of quite detailed information on this site and I hope you find that helpful. In addition the helpline and endocrine nurse line are really useful in helping getting your head round what your diagnosis means.
Sorry for the length of the post but hopefully it makes some sense.
All the best
Tim
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Re: New Diagnoised - Tumour Size Query?

Postby Marc_U » Sat Dec 09, 2017 11:26 pm

Hi Tim,

Thanks for your response, as I was reading it, I suddenly realised that I had probably been mis-reading my report :oops:

I was thinkin that it was saying that there are seven 8mm adenomas on my pituitary gland - which sounds a lot, and very crowded

rather than there is a single 7mm by 8mm adenoma - which sounds much more reasonable.

Unfortunately my adenoma is composed of functional cells, and I have an over-production of the IGF-1 (107.4 nmol/L)

Thanks very much for clarifying my thinking.

Regards,
Marc
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Re: New Diagnoised - Tumour Size Query?

Postby member_41389 » Sun Dec 10, 2017 9:07 pm

Hi
In that case I guess it's welcome to the Acromegaly club as well. At diagnosis my IGF-1 was about 1260 in some units which I can't remember but equate to 120 or so in new units. Currently my IGF-1 is down to about 56 pmol/ml (which is the same as nmol/l!!) following surgery, radiotherapy and monthly injections of lanreotide. Unfortunately these adenomas can be tough to shift; mine has invaded the left cavernous sinus and is wrapped round the internal carotid artery which is why surgery was less than successful. Every one of us pituitary patients has a different journey, many get on well and manage a normal life whereas others seem to collect every side effect under the sun.
Hope things are going well for you at the moment and keep in touch.
Tim
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