possible pitituary tumor and regrowth

[cursed2cured]

i have an appointment to have my moobs removed within 2 weeks, but i have a problem.

i got blood work done and turns out my prolactin is at 21ug/mg (3-14 was listed in normal range on the paper). i have yet to get an MRI to see if its caused by a tumor.

ive only recently got gyno, withn the last 8 months. i took steroids and Tren was in that cycle (raises prolactin). thing is ive been off sense april or march now, and the gland itself was very small during the end of the cycle (i didnt have gyne before it) so i stopped, and PCT was used. about a month after PCT my G got alot bigger...

my question is, assuming its a tumor, and i go ahead with the surgery, and i take cabergoline, dostinox, or bromo (all drugs that lower prolactin levels) and i keep my prolactin levels low, will this prevent prolactin G? or regardless of my prolactin levels, would the tumor make the G re-grow???

[Dr. Elliot Jacobs]

Complex question -- and I can only report on two patients of my own who had gyne and who had prolactinomas (the pituitary tumor).  They were on Dostinex and will continue on the medication indefinitely.

After discussion with the endocrinologist, we decided to proceed with gyne surgery with the implicit understanding of the patient that it was possible that the gyne could recur.

So far (2 and 3 years out), neither patient has had a recurrence of his gyne. 

Every case is different -- you should have an in-depth discussion with your gyne surgeon and your endo -- and even if surgery is performed, there are no guarantees.

Dr Jacobs

[DrBermant]

i have an appointment to have my moobs removed within 2 weeks, but i have a problem.

i got blood work done and turns out my prolactin is at 21ug/mg (3-14 was listed in normal range on the paper). i have yet to get an MRI to see if its caused by a tumor.

ive only recently got gyno, withn the last 8 months. i took steroids and Tren was in that cycle (raises prolactin). thing is ive been off sense april or march now, and the gland itself was very small during the end of the cycle (i didnt have gyne before it) so i stopped, and PCT was used. about a month after PCT my G got alot bigger...

my question is, assuming its a tumor, and i go ahead with the surgery, and i take cabergoline, dostinox, or bromo (all drugs that lower prolactin levels) and i keep my prolactin levels low, will this prevent prolactin G? or regardless of my prolactin levels, would the tumor make the G re-grow???

When there is an underlying medical cause of gynecomastia, such as a pituitary tumor, stabilization is typically better before surgery.  Shreds of gland remain after any surgical technique that can regrow if the problem is not addressed first.  Yes, I have seen patients with such problems have recurrence when other surgeons rush to the operating room to do their gynecomastia surgery, make their money, and hope that the patient can then be stabilized by Endocrinology after surgery.  I can remember two such pituitary microadenoma gynecomastia recurrences operated before stabilization by other surgeon.  So when there is breast growth and pain before surgery, I recommend for my patients waiting until the medical treatment can take hold, stabilize the problem first, and then perform the surgery.  In many cases, these tumors can be stabilized by medical treatment.  Although there is still a chance for recurrence, the risk is much less.  I have had several patients with pituitary tumors stabilized, then had my gynecomastia surgery and not yet have a recurrence.

Targeting gland first and removing as much gland as possible such as with my Dynamic Technique may help in situations where the underlying problem cannot easily be addressed. Here is one such case of recurrence from another surgeon's incomplete removal of gland on a patient with Revision Surgery for Recurrence of Gland Growth From Untreated Congenital Adrenal Hyperplasia. The patient opted for revision surgery because he was in a no win Endocrine situation. He was really a genetic she misdiagnosed for years by many other doctors. Fixing the adrenal defect would remove his only inside source of male hormones. That late in life, he did not want to let his body revert from male to female nor be forced to use male hormones to remain male.  His recurrence after the first surgery was quick.  He is now more than a year out after my revision, holding off medical treatment, and no recurrence.

You can learn more about the strange condition of Congenital Adrenal Hyperplasia.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[Paa_Paw]

After two excellent responses from our Doctors, shat could this old man possibly say that would be of any importance?

The original post implies drug usage, specifically steroids. The language also conveys the idea that the person is quite comfortable with medical terminology etc. I think it is fair to assume that the writer has knowledge of these things which is somewhat above the average.

Even so, I think it is important to point out the old adages: "The man who treats himself has a fool for a Doctor." and "The Doctor who treats himself has a fool for a Patient."

I think it is great to become informed and even participate in discussion with your Doctor about treatment options. Ultimately you will reach a point where treatment decisions are to be made. At that point, leave the decisions to the professional.

Adjustment of the hormones and your reproductive physiology is not a Do-It-Yourself job.