“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 September 2024

Musician battles craniopharyngioma

An Irish DJ and music producer with the group Bicep named Matt McBriar is recovering after surgery for a large craniopharyngioma.  Read more: https://www.msn.com/en-us/health/other/bicep-s-matt-mcbriar-treated-for-large-and-pretty-rare-brain-tumour/ar-AA1oLDvU?apiversion=v2&noservercache=1&domshim=1&renderwebcomponents=1&wcseo=1&batchservertelemetry=1&noservertelemetry=1

Social media obsession with “cortisol face” masks true pituitary origin

The term “cortisol face” is sweeping social media, with influencers claiming that stress causes high cortisol levels and leads to puffy cheeks, or “moon facies” that can  be treated with diet, creams or lifestyle changes. But doctors say this is misinformation – and true moon facies come from a pituitary disorder. Read more: https://athletechnews.com/cortisol-face/

New study challenges link between cadaver growth hormone and Alzheimer’s

A new study raises objections to past research that linked cadaver-derived human growth hormone with Alzheimer’s disease.  Read more: https://www.thetransmitter.org/alzheimers-disease/skeptics-challenge-claims-of-alzheimers-disease-transmission-via-growth-hormone/

Pituitary story: At ten years old, 6’3” boy battles gigantism

A story in the Daily Mail recounts the case of a ten-year-old boy from the U.K. names Jayson who stands 6’3” tall and battles pituitary gigantism. Read more: https://www.dailymail.co.uk/femail/article-13489681/rare-condition-harsh-realities-tallest-kid-world.html

Pituitary story: 62-year-old Indian man undergoes transsphenoidal surgery

An article in City Air news looks at the case of a man in India who had transnasal transsphenoidal surgery to remove a pituitary tumor. Read more:

https://www.cityairnews.com/content/doctors-remove-complex-brain-tumor-in-62-yr-old-man-through-nasal-route-restore-his-vision

Research Articles

September 2024 Research Articles

Pituitary Adenoma

Does size really matter? A closer look at the absolute size of growth hormone-secreting pituitary adenomas.

 

Ectopic Intrasphenoidal Growth Hormone Releasing Pituitary Adenoma Associated with an Intracranial Aneurysm.

 

Granulomatous Mastitis: An Initial Presentation of Undiagnosed Prolactinoma.

 

Induction of apoptosis by oridonin in nonfunctioning pituitary adenoma cells.

 

Pituitary Surgery


Smartphone Applications for Remote Monitoring of Patients after Transsphenoidal Pituitary Surgery: A Narrative Review of Emerging Technologies.

 

Intraoperative Takotsubo Syndrome.

 

Feasibility of Early Surgical Treatment for Adolescent Patients with Prolactinoma: A Case Report and Literature Review.

 

 Benefit of Optical Coherence Tomography-Angiography in Patients Undergoing Transsphenoidal Pituitary Adenoma Surgery: A Prospective Controlled Study.

 

Acromegaly


Unlocking the Genetic Secrets of Acromegaly: Exploring the Role of Genetics in a Rare Disorder.

 

Cushing’s


An aggressive Cushing’s syndrome originating from a rare thymic neuroendocrine tumor, controlled successfully with fluconazole and octreotide therapy before surgery.

 

Pituitary Neuroendocrine Tumors


Pituitary Neuroendocrine Tumors in Multiple Endocrine Neoplasia.

 

Hormonal Health

Hypothalamic-pituitary-adrenal axis functioning in offspring of parents with a major affective disorder: a meta-analytic review.

An Overview of Cardiovascular Risk in Pituitary Disorders.

 

Dysregulated zinc homeostasis and microadenomas in the anterior pituitary: pathological insights into suicide risk.

  
A Rare Case of Invasive Aspergillosis of the Pituitary Gland in a Young Immunocompetent Host: Diagnostic Pitfalls and Postoperative Complications.

Altered individual-level morphological similarity network in children with growth hormone deficiency.

Oral Levodopa Stimulates Copeptin Secretion in Children and Adolescents with Intact Posterior Pituitary Function.

 

 

 

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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