Q:

When should a repeat MRI be done for pituitary postoperative?

waelhammad
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2022-11-18
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A 45-year-old lady presents with complaints of a progressive increase in the size of hands and feet and shoe size for past 5 years. The family members have noticed a change in her facial appearance in the form of coarsening of features and her voice has become sonorous. She also has complaints of frequent headaches for past 1 year. She complains of amenorrhea for past 5 years. She also has complaints of joint pains for past 3 years which have become more severe for the past 3 months. She is hypertensive for past 1 year and complaints of grade 2 dyspnea on exertion and her hypertension is controlled on 10 mg of cilnidipine and 40 mg of telmisartan. She is not a known diabetic and has checked her random sugars 1 week back which was normal. She is not on any other medications presently (Fig. 1.1).

When should a repeat MRI be done for pituitary postoperative?

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waelhammad
2022-11-18
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It should be done at 12 weeks after surgery to see for the size of residual tumor. This patient in case 1 undergoes a postoperative evaluation for pituitary hormones after 6 weeks of surgery and she is found to have secondary hypo- thyroidism and cortisol deficiency. Her postoperative GH levels are 8 ng/mL (growth hormone suppression test) and her IGF-1 levels are 360 ng/mL at 12 weeks post surgery. Her pituitary MRI shows a small residual lesion of 6 mm in size which is done after 12 weeks of surgery.

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