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ElProlactintoday at 2:48 AM2 repliesview on HN

I had a (micro)prolactinoma that was successfully treated with medication. Even though it was nowhere near as "bad" as this man's girlfriend's, getting it diagnosed took almost 2 years and the possibility of prolactinoma was dismissed outright by several doctors.

It should be pointed out that the pituitary gland sits at the base of the brain and prolactinomas are not technically considered "brain tumors" because they're not in the tissue of the brain. So it's a mischaracterization to keep referring to this as a "brain tumor" and a bit of an odd one for someone trying to start a medical research effort.

Unfortunately, the reality is that sometimes life just doesn't deal you a good hand. I think it's sad this man is talking about children when prolactinomas are a leading cause of infertility and it sounds like, for a variety of reasons, this man's girlfriend has one that is very difficult to treat. While it's OK to always hope, it's also possible to cling to false hope so strongly that it prevents you from accepting and moving forward with the life you have instead of the life you envisioned.


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loupradotoday at 5:09 AM

Agreed that initially referring to it as "brain tumor" would have been fine.

Thanks for sharing your story too, perhaps this condition isn't rare. Coincidentally I once went into bar and vaguely recognized a roommate I hadn't seen in years. His appearance had changed and he now had remarkable Hulk like features. I restrained myself from asking but I honestly thought he looked great.

We chatted and he shared that he had "brain surgery" 2 weeks(?) prior to remove a tumor on his pituitary gland. He just woke up one day and his vision was distorted. The next day he woke up blind which lead to him getting a diagnosis and surgery. The tumor had also caused pituitary disfunction which induced giantism.

If I recall, the surgery was performed going behind his nose through an incision in his mouth above the posterior of his upper lip which differs slightly from the approach in the OP. It's amazingly fortunate that this is an option given it looks inoperable from the MRI.

I'll also share that towards the end of our conversation he thanked me for not commenting on his appearance and that he was self-conscious. It's compelling, especially when someone looks good, to mention it, but there's no need to lead with it.

hsuduebc2today at 4:20 AM

If I understand it correctly, a prolactinoma can make it harder to have children mainly because high prolactin can disrupt ovulation, but it does not automatically mean having a child is impossible. In many cases, treatment brings prolactin back to normal and fertility can return. And if carrying a pregnancy is not possible for medical reasons, there can still be options like IVF, and having someone else carry the pregnancy where it is legal and appropriate. So it may be more complicated and it can be very hard in some cases, but it is not an absolute dead end. A hopeless tone is not very useful here because it can discourage people from exploring realistic options and evidence based treatment paths.

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