Hemorrhagic pituitary tumor, causing blurred vision
The patient was diagnosed with a pituitary tumor compressing the nerve, size 1.5 x 2.5 cm, had cerebral hemorrhage and was at risk of blindness.
MSc.BS.CKII Chu Tan Si (Head of the Department of Neurosurgery, Center for Neurology, Tam Anh General Hospital in Ho Chi Minh City) said that Ms. Nguyen Thi Tinh (35 years old, Binh Duong) came to the hospital for a check up in the middle of the day. March with visibility, viewing angles are reduced.
Ms. Tinh said that she often had headaches, especially the pain for nearly a month now suddenly as heavy as a hammer, then gradually reduced but smoldering without stopping. Recently, she had additional symptoms of blurred vision, so she went to the doctor.
The results of magnetic resonance imaging (MRI) showed that she had an intracranial pituitary tumor that had hemorrhaged. Tumor is scattered, both old hemangioma and new hemangioma, the tumor is growing fast, currently 2.5 cm high and 1.5 cm long. The tumor presses on the optic nerve, causing blurred vision.
Doctor Tan Si said that the pituitary tumor was large and hemorrhagic, causing hypothyroidism. Without early surgery, the patient is at risk of blindness and hypothyroidism.
Doctor Chu Tan Si analyzed the location and path to the patient's pituitary tumor. Photo: Provided by the hospital
According to Dr. Phan Van Dinh, the team chose an incision that goes from the nose to the tumor, starting from under the sphenoid sinus and going up to the brain, about 12 cm deep. Although this approach is deep and difficult, it is less invasive, does not have to open the brain, and causes the least damage to the patient. The navigation device helps to safely approach the tumor without collision or mistakenly cutting into the nerve fiber bundles, avoiding postoperative sequelae. Thanks to the microsurgery system, doctors can control tumors, stop bleeding, and cut bones accurately. The surgery took place in two hours, completely removing the tumor.
After surgery, the patient recovered vision, continued to be monitored for 2 hours. After 3 days, the patient's health improved well and was discharged from the hospital, requiring periodic re-examination.
The surgeons left the tumor for the patient in mid-March. Photo: Provided by the hospital
The pituitary gland controls the endocrine system in the body. The surgical technique to remove pituitary tumor is not difficult, but this tumor is quite tough, bleeding a lot and stopping bleeding is quite difficult. If the doctor does not have much experience, he will not remove the tumor and easily tear the arachnoid membrane, draining cerebrospinal fluid from the brain, causing very severe meningitis. In the absence of specialized equipment and techniques to help shrink the tumor, the whole tumor must be picked up, pulling a lot and strong force will affect the pituitary gland. If the pituitary gland has a sudden hemorrhage, lack of blood supply causes total pituitary insufficiency - pituitary stroke, emergency surgery is required.
Usually, if the tumor is less than one centimeter, the doctor may not intervene, but follow-up for two years is required. If the tumor increases in size, the gamma knife technique helps to avoid a future surgery, but is usually indicated for young people.