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What are the symptoms of CUSHINGS DISEASE? MRI PITUITARY GLAND.

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Hello I have an mri album of my pituitary gland.
https://imageshack.com/a/Ghiz/1

I need a neurosurgeon who has experience viewing mri's of pituitary gland, to see if there is a tumor.

Symptoms I have are mostly of cushing's disease & hypothyroidism:
Blurred vision.
Cluster headaches above right eye.
Large Dark purple stretch marks on, around, & under belly that have not faded in color for over a year. I have them also under my armpits.
Pot belly, with thin arms, thin legs.
Unable to lose weight with proper diet & exercise.
Dark spots on my knee caps, underarms & elbows.
Bruise on hip has not healed after 6 months.
Hair loss, thinning of hair, premature graying.
Depression, anxiety.
Brain fog. Poor memory. Poor concentration.
Abnormal sleep rhythm can only fall asleep during 5am-10am.
Fatigue
Not feeling full after a meal.
Frequent urination at night only.

I have had some cortisol tests done.
I have a midnight serum cortisol of 11ug/dL. The max range is 7.5ug/dL.
An ACTH of 49.09 in a 7.2-63.30pg/ml range.
My 8am cortisol was suppressed with an overnight dex test. 0.351 in a AM: 6.2-19.4UG/DL.

Here's a link to some pictures & labwork.
https://imageshack.com/a/RHiz/1






Category: Neurosurgeon

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Category: Spine Surgeon
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From the MRI I do see a pituitary microadenoma. Your endocrinologist will be the best guy who can suggest you whether to continue medical management or is there a need for surgery. Pituitary adenomas are non cancerous, ( 0.1-0.2 % incidence ), and they are also non-invasive, mostly not capable of causing a lot of substantial damage.



Risk of surgery for patients with Cushings is high with relatively low success rates...



Regards



 



Patient replied :

Can you leave a comment on the pictures that have a microadenoma? Because the radiologists who took these said there was no tumor.


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In the sagittal images of the pituitary fossa, the whole of bright structure is the tumour. The normal pituitary gland is dark in color.




I can describe better if I have coronal images, early contrast and delayed contrast images of the pituitary.









Regards








Patient replied :

The mri album earlier had early contrast and delayed. They injected me twice, once between the scan & another during the scan with galdonium.
I think you are referring to these two pictures I marked with red circles?


Thanks for writing to us again.


Yes. The red circle which you have marked in the attached images is the one which points to the pituitary tumour. Patients with cushing's are very poor and high risk candidates for surgery. The line of treatment will be best guided by a endocrinologist. Kindly consult your endocrinologist, so that he can start the treatment regimen soon. In my opinion, its best to control your symptoms medically, since medicines can block the hormones that's been produced in your body, and it will lead to relief from your symptoms. Hence the Endocrinologist opinion is recommended.
Based on his opinion, and treatment regime we can decide if radiation might be required in the future. Also just to reinforce these tumors are non cancerous. That's the good part. Kindly get an opinion and get back to me for additional information.
Regards










Dr. Goutham Cugati
Category: Spine Surgeon
Experience: 
Residency: Neurosurgery, the Post-Graduate Institute of Neurological Surgery, Dr. Achanta Lakshmipathi Neuro surgical Center, VHS Hospital, Chennai, 2011

Postgraduate in Neurosugery: DNB, National Board of Examinations,
Part 1 - 2008, Part 2 -  2010

Medical School: Bachelor of Medicine, Bachelor of Surgery, JSS Medical College, 2004
Dr. Goutham Cugati and 4 other Medical Specialists are ready to help you

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