I have got my MRI done recently and want a second advice from you :-

the report is : The pituitary gland appears rounded in apearance and measures 12×11x10 mm. A 9×8x9 mm ill defined mass leison is seen within the centre of the pituitary gland which apears isointense on T1W1 and T2w1 with delayed hetrageneous enhancement on post contrast sequences. The superior convex margin of the pituitary gland is seen displacing the pituitary stalk and closely abutting the optic chiasma with obliteration of infundibular & optic recesses and effacement of th suprasellar cistern. No evidence of necrosis/ calcification is seen within the leison.
Posterior pituitary bright spot appears normal in morphology and signal intensity. The hypothalamus and visualised brainstem appear normal. Cavernous sinuses and ICA’s show normal morphology and signal intensity characteristics.
IMPRESSION : Features are consistent with pituitary microadenoma.

I want to know, how serious is this and will this need surgery ? or this can be treated with medicine itself ? I am a female and have had problems of increased prolactin and have taken bromocriptin for controling the same.

Dr. Joshua’s Answer:

Medical treatment (bromocriptine) may be sufficient. Bromocriptine normalizes prolactin levels in most patients, and often decreases tumor size. Surgery is considered if there is no response to medical treatment. Bromocriptine does not cure the adenoma, in other words it does not remove the cause. Succesful total surgical removal results in complete cure, but it is not guaranteed as some tumor may be left and regrow. This happens in 15-20% of cases. Surgery, when needed, should be performed by a specialist pituitary surgeon using the transsphenoidal (through the nose) approach. Surgery always carries risks although transsphenoidal surgery in good hands is a low-risk procedure.

I recommend that you talk to your endocrinologist and a neurosurgeon specializing in pituitary surgery if you have further questions. Please do not consider this answer as a second opinion - I only provide information.