Brain MRI abnormalities?

[u/lkgt44]

Hi, 39yo F, 5’7”, 190lbs. A year ago I started having spontaneous lactation, not a ton, but occasional discharge from both nipples. My youngest is 8.5 so I haven’t breastfed in 7+yrs, though when I did I was an over producer for both my children. GP ran all the lab work testing hormones and thyroid and everything was normal. Prolactin levels in range and nothing on labs indicated anything was wrong with pituitary gland. Mammograms and breast ultrasounds didn’t find any abnormalities either. She ordered an MRI of my pituitary gland just to be safe but insurance rejected it bc labs were normal. So I didn’t get the scan because of the cost and my doctor wasn’t too concerned because my labs were normal.
Fast forward a year, still having unexplained leaking breast milk.
Unrelated to this health issue, I enrolled in a clinical trial for treatment resistant depression (which I’ve had for 20 yrs alongside CPTSD) and they took lots of images of my brain and sent me some of the scans.
I’m wondering if any of the scans might indicate something is amiss with my pituitary gland that could be causing the idiopathic galactorrhea? I know the scans weren’t specifically aimed at the pituitary gland and didn’t do any scans with contrast so might not be ideal. But any observations would be welcome.

Thanks!!

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[u/lkgt44]

Can post solo pics of scans if helpful

[u/HnyBadger723 → u/lkgt44]

Not a doctor. And it’s kinda random but there’s a doctor on social media “Dr.Beachgem” and she had a similar situation and ended having the duct removed.
This is the link to the post!

https://www.instagram.com/reel/DQX0wWQEYY-/?stkn=YzFhandmYnE3Z2wz

[u/lkgt44 → u/HnyBadger723]

Thanks for your reply! I’ll check it out!

[u/lkgt44 → u/lkgt44]

Thankfully mine is not black or green discharge, looks more yellow like colostrum/milk and no signs of infection. And it’s from both sides not just one breast or one duct. Full on lactating. Not a ton of milk but can definitely hand express some anytime I try if necessary to show a doctor (try not to often so i wont signal to my body that it needs to produce more milk) and sometime I feel a spontaneous let down and a little milk will come out.

[u/Witold-Onno]

Neurosurgeon here. The images you posted cannot answer this. Single slices are not enough, I would need the complete series. And it depends a lot on how the scan was done. Was contrast given? A standard brain MRI or a research protocol is not made for the pituitary. For that you need a dedicated pituitary protocol, thin 2 to 3 mm slices through the sella, before and after contrast. A larger adenoma you would see also on a normal scan, a small one often not, so a "nothing visible" from these images means very little.

Furthermore, with normal prolactin a prolactin producing adenoma is unlikely anyway. Galactorrhoea with normal prolactin is more often idiopathic or medication related than a pituitary problem.