“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 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.

    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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