“The human body is the best picture of the human soul.” – Tony Robbins

 

 

 

PNA Spotlight: Phillip Cem Cezayirli, MD

This month the PNA Spotlight focuses on neurosurgeon Dr. Philip Cem Cezayirli, part of the Haynes Neurosurgical Group in Birmingham, Alabama. Dr. Cezayirli is affiliated with four local medical centers: Princeton Baptist, Shelby Baptist, Grandview, and Brookwood Baptist Medical Centers.

Dr. Philip Cezayirli

He is a board-certified neurosurgeon with a focus on neurosurgical oncology and spine surgery and is licensed to practice neurosurgery in Alabama.

He earned his MD at the University of Alabama at Birmingham School of Medicine in Birmingham, Alabama. He spent a year studying with Dr. Uğur Türe at Yeditepe University and Hospital in Istanbul, Turkey. He did his neurosurgery residency at the Albert Einstein College of Medicine in Montefiore, Bronx New York. And he completed a neurosurgical oncology fellowship at MD Anderson Cancer Center in Houston, TX.

Dr. Cezayiri was kind enough to speak with the PNA about a range of issues. Here is the conversation, edited for clarity.

Read More Here

 

Expertise needed for tumors that invade the pituitary’s protective layer

The pituitary gland is surrounded by the cavernous sinus and internal carotid artery. A thin layer of connective tissue separates the sinus and artery from the pituitary gland. Pituitary tumors sometimes invade this protective layer, called the medial wall of the cavernous sinus (MWCS).

That infiltration puts pituitary tumors in close proximity to the internal carotid artery and to cranial nerves, significantly complicating treatment approaches — especially when a tumor needs to be entirely removed to achieve cure.

“Standard procedure would be to resect the pituitary tumor up to the medial wall, to avoid damaging the artery. But if there’s tumor in the wall, the patient won’t be cured,” says Mayo Clinic neurosurgeon Dr. Kaisorn L. Chaichana.

MWCS infiltration is more common with functioning adenomas, such as prolactinomas and tumors that cause acromegaly or Cushing’s disease. Incomplete removal of these tumors can lower the chances of hormone control and increase the risk of tumor regrowth.

Fortunately, neurosurgeons are learning how to meet these challenges. Surgically removing part of the MCWS, to completely resect pituitary tumors, can improve outcomes.

“It’s a formidable challenge,” Dr. Chaichana says. “It takes people well-versed in the surgery, and who have experience, to know where they can open that medial wall. If you’re too far to the side — even by less than a millimeter — you would cut the carotid artery, which would be catastrophic.”

Mayo Clinic neurosurgeons use Doppler ultrasound to guide entry into the cavernous sinus, allowing selective resection of the MWCS. “We listen to the sound of the carotid artery, find a space within the medial wall where the artery isn’t present, and make a small slit in that opening,” Dr. Chaichana says. “Then we remove the wall from the carotid artery.”

It’s also important to limit packing of the cavernous sinus after surgery. “Overpacking that site can cause pressure and injury to the cranial nerves, which could lead to facial numbness and eye motion problems,” Dr. Chaichana says.

A multidisciplinary team that includes ENT/head and neck surgeons, as well as neurosurgeons, provides additional anatomical expertise.

“Very few centers do this procedure. But we’ve seen higher rates of remission for functional tumors when we take out that wall,” Dr. Chaichana says. “For a lot of functional tumors, selective resection of the MWCS can mean the difference between tumor remaining and tumor being gone — and therefore, cure or not cure.”

Featured News and Updates

News Articles October 2025

News Articles October 2025

When Cushing’s becomes cancer: metastasis or induced by radiation?

An article in Cushing’s Disease News looks at a study that examines the case of two women whose benign tumors associated with Cushing’s disease turned malignant.  The question is whether they metastasized or if radiation could have induced the transformation.  More info: https://cushingsdiseasenews.com/news/cushings-pituitary-tumors-rarely-aggressive-cancers/

Pituitary apoplexy: symptomatic vs asymptomatic

A study in the Journal of Clinical Neuroscience looks at the clinical profile of patients with and without symptoms of pituitary apoplexy.  Symptoms include “headache, vomiting and cranial nerve palsies.”  People without symptoms who suffered pituitary apoplexy had lower white blood cell counts and lower blood sodium levels. Read more: https://www.sciencedirect.com/science/article/abs/pii/S0967586825005983

When a pituitary macroadenoma causes sepsis-like symptoms

A study on Cureus.com presents a case report where a woman was initially treated for sepsis but turned out to have a pituitary macroadenoma.  Read more: https://assets.cureus.com/uploads/case_report/pdf/413034/20250912-112610-bm0ldk.pdf

 Acute Sheehan’s Syndrome after post-partum pituitary hemorrhage

A case study presented on Cureus.com looks at the patient who gave birth, suffered a pituitary hemorrhage, and developed acute Sheehan’s Syndome and then pituitary atrophy eight months postpartum. Read more: https://assets.cureus.com/uploads/case_report/pdf/411201/20250914-401650-bm0ldk.pdf

 

Research Articles

October 2025 Research Articles

Pituitary tumors


A new and useful tool for differentiating prolactinomas from non-functioning pituitary adenomas: a pilot study of the cabergoline disconnection test.

Galliano SA, Stumpf MAM, Queiroz NL, Ferreira EHR, Craveiro FL, Gruetzmacher C, Silva GOD, Cescato VAS, Vellutini EAS, Cunha-Neto MBC, Batista RL, Glezer A.Einstein (Sao Paulo). 2025 Sep 15;23:eAO1694. doi: 10.31744/einstein_journal/2025AO1694. eCollection 2025.

 

The evolution and application of multi-omic analysis for pituitary neuroendocrine tumors.

Pugazenthi S, Pari SS, Zhang Z, Silverstein J, Kim AH, Patel B.Front Med (Lausanne). 2025 Sep 1;12:1629621. doi: 10.3389/fmed.2025.1629621. eCollection 2025.

 

Limitations of MRI in differentiating solid and cystic components of craniopharyngiomas.

Karaalioğlu B, Öksüz NÇ, İpek V, Çakır A, Kahraman O, Özbek MA.Childs Nerv Syst. 2025 Sep 16;41(1):281. doi: 10.1007/s00381-025-06941-y.


Idiopathic Arginine Vasopressin Deficiency With an Incidental Non-functional Pituitary Microadenoma in an Elderly Diabetic Woman.

Krishna MSV, Babu DVSP, Singh M, Madhavan S.Cureus. 2025 Aug 13;17(8):e89995. doi: 10.7759/cureus.89995. eCollection 2025 Aug.

 

Cushing’s Disease


Changing face of Cushing’s disease over three decades in pituitary center.

Muradov I, Sahin S, Uysal S, Sulu C, Gunebakan P, Tunc A, Kocaman BB, Soltanova L, Gazioglu N, Tanriover N, Kadioglu P.J Endocrinol Invest. 2025 Sep 16. doi: 10.1007/s40618-025-02702-5. Online ahead of print.

Editor’s note:  Dr. Gazioglu is a member of the PNA.


Update on Medical Treatment of Cushing’s Syndrome.

Dillon BR, Agrawal N, Schwarz Y, Dancel-Manning K, Tabarin A, Lacroix A, Hofland LJ, Feelders RA.Drugs. 2025 Sep 15. doi: 10.1007/s40265-025-02223-8. Online ahead of print.

 

Acromegaly

Metabolic Factors Related to Interpersonal Dysfunction in Acromegaly: A Nationwide Cross-Sectional Study in China.

Tagilapalli SK, Wang Z, Lu YL, Zhang G, Su W, Wu Z, Wang J, Rao Q, Wang H, He D, Mou Y, Yao S, Tie Y, Chen W.CNS Neurosci Ther. 2025 Sep;31(9):e70607. doi: 10.1111/cns.70607.

 

Imaging

Trade-Off Analysis of Classical Machine Learning and Deep Learning Models for Robust Brain Tumor Detection: Benchmark Study.

Tian Y.JMIR AI. 2025 Sep 15;4:e76344. doi: 10.2196/76344.

 

Hormonal health


Idiopathic hyperprolactinemia-associated hypogonadism in men presenting with normal testosterone levels.

Cheng X, Xiao Y, Deng Y, Chen Q, Wen X, Zhou E, Zhou H.PLoS One. 2025 Sep 18;20(9):e0332871. doi: 10.1371/journal.pone.0332871. eCollection 2025.

 

Evaluation of thyrotrophic and lactotrophic reserves in patients with pituitary dwarfism with and without empty sella turcica.

Geremia C, Geremia F.J Pediatr Endocrinol Metab. 2025 Jul 21;38(9):904-914. doi: 10.1515/jpem-2025-0082. Print 2025 Sep 25.

 

 

Count on your Xeris CareConnection™ Team for unparalleled Cushing’s Support

Cushing’s can be challenging, but there is support so patients can feel like themselves again. The main goal of treating Cushing’s is to get cortisol levels back to normal. This Pituitary Awareness Month, Xeris Pharmaceuticals® is highlighting the importance of one-on-one support for patients living with Cushing’s Syndrome and support for HCPs treating Cushing’s Syndrome.

Sign up to get dedicated support:

Patients: Sign up for support | Recorlev® (levoketoconazole)

HCP’s: Connect with Xeris support | RECORLEV® (levoketoconazole)

Have more questions? Call for more support at 1-844-444-RCLV (7258)

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