“Health is a state of complete harmony of the body, mind, and spirit.”

— B.K.S. Iyengar

PNA Spotlight: Dr. Adam Mamelak

This month the PNA Spotlight focuses on Dr. Adam Mamelak, a neurosurgeon and co-director of the Pituitary Center at Cedars Sinai Medical Center in Los Angeles. Dr. Mamelak earned his B.A. in Physics at Tufts University and earned his MD from Harvard Medical School. He did a surgical internship and then a residency at the University of California at San Francisco Medical Center. He did a fellowship at the Epilepsy Research Laboratory at UCSF, and another postdoctoral fellowship in neuroscience at the California Institute of Technology & Huntington Medical Research Institutes in Pasadena, California. Dr. Mamelak was kind enough to answer a series of questions from the PNA.

His answers are below:

PNA Medical Corner: New options for imaging MRI-resistant Cushing tumors

The tiny tumors that cause Cushing disease are tough to detect with standard MRI. Fortunately, some new options are available, boosting the chances for successful treatment.

“Sometimes pituitary tumors are so small, they’re nearly impossible to see,” says Mayo Clinic neurosurgeon Dr. Jamie J. Van Gompel. “The success of surgery drops dramatically when we can’t see these tumors on imaging. Anything that tells us where the tumor is will help us determine the risks of surgery and also improve the chances of long-term cure.”

About half the tumors that cause Cushing disease aren’t clearly visible on standard MRI. Standard MRI provides 2D images of relatively large sections of the pituitary, which might not show a tumor that’s only several millimeters in size. Pituitary MRI is also prone to visual flaws or artifacts.

“It’s hard for MRI to image tissue that’s near air. And the pituitary always has air next to it, from the sinuses,” explains Mayo Clinic neuroradiologist Dr. Ian T. Mark.

    Featured News and Updates

    News Articles December 2025

    Pituitary story: Long road to diagnosis

    A retired Methodist minister from Raleigh, North Carolina named Lib Campbell tells her pituitary story in an article on DailyAdvance.com. She struggled for many years before being diagnosed with a lesion on her pituitary. Read more: https://www.dailyadvance.com/opinion/editorial_columnists/lib-campbell-everyone-is-deserving-of-affordable-health-care-insurance/article_d8ba7dd4-0d19-5eff-80d6-97fa1b598855.html

    Pituitary case study: Early signs of acromegaly

    Cureus.com features a case study on a 35-year-old man who went to the emergency room for dizzy spells.  He also suffered from night sweats, his face was changing progressively, he snored and stopped breathing while resting. Tests showed a pituitary tumor; doctors diagnosed him with acromegaly.  Read more:

    https://www.cureus.com/articles/433166-growth-hormone-secreting-pituitary-macroadenoma-diagnosis-of-acromegaly-in-a-young-adult?score_article=true#!/

    Pituitary story: Soccer teammates come to the aid of 12-year-old pituitary patient

    An article in the Connaught Tribune follows the story of a young girls’ soccer team in Ireland that is raising money toward medical care for two of the young teammates. A 12-year-old girl named Aoife is battling a pituitary tumor, and her friend, 13-year-old Emma has been diagnosed with Langerhans cell histiocytosis.  Read more: https://connachttribune.ie/football-community-unites-behind-young-team-mates-both-battling-serious-illness/

    Study examines role of age, gender, and stress in pituitary lobe volume

    A study featured in Nature.com looks at the way the posterior and anterior lobes of the pituitary change over time and show differences according to gender and stress level. Results show that older adults had a smaller anterior lobe and a larger posterior lobe. They also showed less stress. Women generally have a larger anterior lobe than men.   Read more: https://www.nature.com/articles/s41598-025-26558-0

    Research explores autism in children whose mothers suffer thyroid imbalance in pregnancy

    An article in Science Daily looks at an Israeli study that found that mothers who experience thyroid hormone imbalance in pregnancy and go untreated have a higher risk of bearing children with autism. They recommend thyroid checks in pregnancy, as the risk decreases when the thyroid issue is treated. Read more:  https://www.sciencedaily.com/releases/2025/11/251129053353.htm

    Research Articles

    Research Articles December 2025

    Pituitary tumors

    Mapping the evolution of pediatric craniopharyngioma research: a bibliometric analysis.

    Frome S, Dastagirzada Y, Kurland D, Wisoff J.Childs Nerv Syst. 2025 Nov 29;41(1):389. doi: 10.1007/s00381-025-07050-6.


    The interdisciplinary management of craniopharyngioma – practice patterns, outcomes, and insights.

    Haselmann J, Roohani S, Wasilewski D, Onken J, Capper D, Kaul D, Ehret F.BMC Cancer. 2025 Nov 28. doi: 10.1186/s12885-025-14991-3. Online ahead of print.

     

    Pituitary Surgery

    Training in endoscopic endonasal surgery: EANS young neurosurgeons committee survey.

    Zoli M, Aldea C, Bauer M, Belo D, Drosos E, Jadoon S, Kaprovoy S, Lepic M, Lippa L, Mohme M, Motov S, Spiriev T, Stastna D, Stengel FC, Raffa G.Neurosurg Rev. 2025 Nov 28;49(1):31. doi: 10.1007/s10143-025-03962-8.


    Very Long-Term Follow-Up of Multidimensional Health-Related Quality of Life After Endoscopic Endonasal Surgery for Pituitary Adenomas: A Prospective Cohort Study.

    Joustra GE, van Rhee NF, den Heijer MC, Korsten-Meijer AGW, Feijen RA, Halmos GB, Kuijlen JMA, Vermeulen KM.Head Neck. 2025 Nov 28. doi: 10.1002/hed.70103. Online ahead of print.’

     

    Cushing’s Disease

    Hypercoagulability in Cushing’s syndrome: past, present, future.

    Akirov A, Fleseriu M.Arch Endocrinol Metab. 2025 Nov 28;70(special 1):e250062. doi: 10.20945/2359-4292-2025-0095.Review.

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


    Revamped perspective on conventional interpretation: the foreboding prognostic significance of low-lateralization in inferior petrosal sinus sampling for diagnosis of Cushing’s disease.

    Lyu X, Liu J, Zhang D, Zhang X, Zhu H, Chen S, Lu L, Pan H.BMC Endocr Disord. 2025 Nov 27;25(1):275. doi: 10.1186/s12902-025-02092-y.

     

    Hypophysitis

    Primary hypophysitis: Classification review.

    Turin CG, Kleinschmidt-DeMasters BK.J Neuropathol Exp Neurol. 2025 Nov 29:nlaf135. doi: 10.1093/jnen/nlaf135. Online ahead of print.41317043


    An update on hypophysitis.

    Miquel L, Testud B, Albarel F, Appay R, Graillon T, Cuny T, Dufour H, Ebbo M, Brue T, Jarrot PA, Schleinitz N, Castinetti F.Nat Rev Endocrinol. 2025 Nov 27. doi: 10.1038/s41574-025-01200-1. Online ahead of print.

     

    AI/ Machine Learning

    Multiclass Brain Tumor Detection with Attention-Embedded CNN Framework: Advancing Toward Decentralized Deep Learning-Based Health Monitoring.

    Subba AB, Sunaniya AK, Mukherjee A.IEEE J Biomed Health Inform. 2025 Nov 27;PP. doi: 10.1109/JBHI.2025.3638154. Online ahead of print.

     

    Hormonal health

    Differential role of anterior and posterior pituitary lobes in healthy aging and perceived stress.

    Doucet GE, Davis M, Mertens AT, Picci G.Sci Rep. 2025 Nov 27;15(1):42409. doi: 10.1038/s41598-025-26558-0.

     

    Ki-67 and preoperative hypocortisolism are predictive factors for postoperative diabetes insipidus after endoscopic pituitary tumor resection.

    Li G, Li M, Xie B, Chen J, Li S, Luo S, Mo C.World Neurosurg. 2025 Nov 28:124692. doi: 10.1016/j.wneu.2025.124692. Online ahead of print.

     

    Large-scale comparison of two immunoassays for adrenocorticotropic hormone in human plasma.

    Li Y, Louie JZ, Burgess TE, Bare LA, McPhaul MJ.Sci Rep. 2025 Nov 29. doi: 10.1038/s41598-025-26501-3. Online ahead of print.

     

    disease – From function to the diagnosis of a deficiency, resulting clinical relevance, and potential treatment options in endocrinology.

    Leibnitz S, Christ-Crain M, Atila C.Arch Endocrinol Metab. 2025 Nov 28;70(special 1):e20250259. doi: 10.20945/2359-4292-2025-0259.Review.

     

    Diagnostic/Research

    EndoCompass Project: Research Roadmap for Reproductive and Developmental Endocrinology.

    Cools M, Krausz C, Juul A, Macut D, Andersen MS, Andersson AM, Andoniadou CL, Ahmed SF, Bakker J, Bashamboo A, Behre HM, Bonomi M, Busch AS, De Roo C, Dessens A, Fakhar-I-Adil M, Fanelli F, Fisher AD, Flück C, Gambineri A, Giwercman A, Gravholt CH, Hannema S, Heindryckx B, Hiort O, Hornig NC, Howard S, Ibáñez L, Jensen MB, Jørgensen N, Livadas S, Lucas-Herald A, Mastorakos G, Meriggiola MC, Ong K, Palibrk MO, Pignatelli D, Pitteloud N, Rajpert-De Meyts E, Rey R, Robeva R, Pozza C, Schlatt S, Spaggiari G, Tack L, Tena-Sempere M, Tournaye H, T’Sjoen G, Van Mello N, Vena W, Yildiz BO, de Zegher F.Horm Res Paediatr. 2025 Nov 27:1-23. doi: 10.1159/000549203. Online ahead of print.

     

    EndoCompass and Neuroendocrine Tumor Endocrinology.

    Castano JP, Dattani MT, Grozinsky-Glasberg S, Karavitaki N, Pavel ME, Andoniadou C, Alexandraki K, Capatina C, Cerbone M, Ferone D, Gan HW, Hofland J, Hofland L, Ibanez-Costa A, Ilie MD, Isidori AM, Korbonits M, Kos-Kudła B, Maghnie M, Mantovani G, Marazuela M, Raverot G, Scarpa A, Schilbach K, Theodoropoulou M, van Santen HM, Zatelli MC.Horm Res Paediatr. 2025 Nov 27:1-16. doi: 10.1159/000549145. Online ahead of print.

     

    The FDA has approved NGENLA (somatrogon-ghla)

    The FDA has approved NGENLA (somatrogon-ghla), a once-weekly, human growth hormone analog indicated for treatment of pediatric patients aged three years and older who have growth failure due to an inadequate secretion of endogenous growth hormone.

    See the Press Release here>

    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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