Expert: Claes-Gustaf Nordquist, M.D. - 11/29/2008

Question
QUESTION: My wife since the age of 14 (now 33) has had Cushion's disease.  The first instance the tumor was located on her pituitary gland and the tumor was surgically removed.  The second 7 years later came back again on her pituitary gland and this also surgically removed along with the whole pituitary gland and stork.  7 years later (again) the tumor came back (put down to residual tissue remnants in the pituitary fossa) and this time surgery was done but on the removal of both adrenal glands.  We were told that this would stop the growth of any ACTH stimulating tumor.
Now 33 she has just found out that she once again has a tumor that is located in the right lateral aspect of the pituitary fossa extending into the cavernous sinus.  She has been told that she is probably developed Nelson's disease.  The tumor has completely wrapped itself around the carotid artery.  She will in the new year undergo a 6 week radiotherapy course.
My question to you is a tumor that has wrapped itself around the carotid artery can it cause headaches and can it also cause a stroke if not treated promptly??
Your answer to my questions would be greatly appreciated.
Best regards

ANSWER: This is not a good situation. A tumor with this behaviour and where radiation therapy is planned may be malignant. If so anything may happen. To better evaluate that is there any recent biopsy pathology report of the tumor? If there is please copy it here! That would make any evaluation much better!


---------- FOLLOW-UP ----------

QUESTION: Thankyou for your quick response.  All previous tumor biopsy's have shown the tumors to be benign.  We have been told that this tumor is more than likely a benign growth also.

Answer
It is? Well it seems to behave in a rather malignant way and conventional radiation therapy is rather rarely used on benign tumors. I would very much appreciate a copy of the most recent pathology report to better evaluate this and to be able to give you as good an advice as possible. You can copy it here.