Pituitary Story: Cop, Mother, Pituitary Patient
3-year-old Michael Johnson is about to become a big brother. But that might never have happened. In fact, he might never have happened – if his mom hadn’t sought out the help of an expert pituitary surgeon.
Michael’s mom is 37-year-old Lakisha Jones Johnson, a no-nonsense beat cop from from Haledon, New Jersey with the Passaic County Sheriff's Department. In 2012, still single and child-free, she went to the gynecologist for a routine screening when the doctor asked how long her breast had been discharging milk. Lakisha said it had been happening for 2 or 3 years but she didn’t think anything of it. She had googled it and read that some people just lactate for no reason, that it can be harmless. But now, looking back, she realizes that she had other symptoms. She often lacked energy and focus, had missed some periods and suffered from headaches.
The O-B referred her to a specialist, who did an M.R.I. and discovered a tumor. That doctor diagnosed her with a prolactinoma and put her on bromocriptine. But her symptoms didn’t go away and in fact seemed to get worse.
So she sought out a second opinion, this time from Dr. James K. Liu, a respected neurosurgeon and Director of the Center for Skull Base and Pituitary Surgery, and an Associate Professor of Neurological Surgery & Otolaryngology with Rutgers University-New Jersey Medical School, Neurological Institute of New Jersey. Dr. Liu (who is also a member of the PNA) quickly realized that she had been misdiagnosed, and that the bromocriptine/dopamine agonist therapy was ineffective in shrinking the tumor, resulting in continued tumor growth and compromised vision from compression of her optic chiasm. He determined that instead Lakisha suffered from a nonfunctioning tumor compressing the pituitary stalk that resulted in prolactin elevation. He recommended endoscopic endonasal transsphenoidal surgery and promised to do everything in his power to save the gland and restore her fertility.
Jones, however, was not convinced and sought out a third opinion at a cancer center in Philadelphia. There, the neurosurgeon assured her that he had done many pituitary surgeries but warned that the pituitary gland might be compromised, and she might never be able to have children. When she mentioned her visit to Dr. Liu, the surgeon said he had actually taken a class from Dr. Liu, who is a respected expert in the field. So the student had the humility and integrity to point Jones back to his teacher.
Jones returned to Dr. Liu, who performed the surgery in November 2012. The tumor was completely removed endoscopically and the pituitary gland and function was preserved. The improvement was immediate. No more headaches. Improving vision. No more milky discharge. She had so much energy, she went through with her wedding plans a few weeks later, tying the knot on 12/12/12. Two months later, while she was supposed to be on bed rest, she became pregnant with Michael.
Now she and her husband are anxiously awaiting the birth of little Mason in the end of March. She wants to thank Dr. Liu and Dr. Jean Anderson Eloy, her otolaryngologist. Her advice for other people who suspect something may be wrong? “My advice is to get a good check-up. Get the full check-up ask for the MRI. Do whatever you can to get a full screening. Because I would never have thought I was walking around with a tumor in my head. It was a real shocker to me!”
Dr. Liu’s advice is to seek out an expert specializing in pituitary tumors who can differentiate a non-functioning pituitary adenoma from a true prolactinoma, because misdiagnosis by non-pituitary specialists and inappropriate treatment is not uncommon and can result in consequences of persistent tumor growth.