“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 November 2025
News Articles November 2025
Case report: from pituitary tumor to metastatic cancer
An article on Cureus.com looks at the case of a 35-year-old man with a lactrotroph pituitary adenoma that progressed to a metastatic pituitary carcinoma. In this rare case, the cancer is “resistant to surgery, radiation, and medical treatments.“ Read more: https://www.cureus.com/articles/348490-transformation-of-lactotroph-pituitary-adenoma-to-metastatic-pituitary-carcinoma-a-case-report#!/
Patient story: Musician Lou Gramm on his battle with a pituitary tumor
An article on blabbermouth.net features the pituitary story of musician Lou Gramm of the group “Foreigner”, who had surgery for a craniopharyngioma in 1997 after suffering headaches and memory loss. Read more: https://blabbermouth.net/news/lou-gramm-says-he-couldnt-remember-the-words-to-foreigners-classic-songs-shortly-after-his-brain-surgery
Researchers use artificial intelligence to screen for childhood hormone deficiency
An article in EMJ Reviews looks at a study on whether artificial intelligence can predict growth hormone deficiency in children of short stature. The machine learning model examines MRI scans of the pituitary and has shown good results. In the future, this could lead doctors to order fewer invasive growth hormone stimulation tests for children. Read more: https://www.emjreviews.com/en-us/amj/radiology/news/mri-radiomics-model-predicts-childhood-hormone-deficiency/
Patient on off-label cabergoline develops impulse control disorder as tumor grows
An study in Cureus.com examines the case of a 19-year-old man with a prolactinoma who was given off-label cabergoline at three times the normal dose for ten years. He developed an impulse control disorder and a spending and gambling problem, and was lost to follow-up. Radiosurgery was rejected, as the patient was deemed unable to comply with the necessary follow-up regime. It was later discovered that his tumor was resistant to cabergoline and had grown and extended into the cavernous sinus, making it inoperable. Read more: https://www.cureus.com/articles/416467-giant-prolactinoma-resistant-to-high-dose-cabergoline-in-a-young-male-lost-to-follow-up#!/
Research Articles
November 2025 Research Articles
Pituitary tumors
Zhang B, Zhang J, Li Z, Sheng H, Li H, Lu Y, Liu X, Xu Z, Huang Y, Zhu C, Wen Y, He X, Zhang L.Neuro Oncol. 2025 Oct 24:noaf249. doi: 10.1093/neuonc/noaf249. Online ahead of print.
Patel V, Aboud O, Barakat A.Int J Mol Sci. 2025 Oct 16;26(20):10065. doi: 10.3390/ijms262010065.
Pituitary surgery
Global Growth and Distribution of CyberKnife Stereotactic Radiosurgery: A Bibliometric Analysis.
Annagiri S, Hori YS, Persad ARL, Ustrzynski L, Emrich SC, Tayag A, Park DJ, Adler JR, Chang SD.Neurosurg Pract. 2025 Jul 10;6(3):e000150. doi: 10.1227/neuprac.0000000000000150. eCollection 2025 Sep.
Imaging
Korbecki A, Łukasiewicz M, Kacała A, Sobański M, Zdanowicz-Ratajczyk A, Szałata K, Dorochowicz M, Korbecka J, Trybek G, Zimny A, Bladowska J.J Clin Med. 2025 Oct 11;14(20):7168. doi: 10.3390/jcm14207168.
Yonar A.Sci Rep. 2025 Oct 28;15(1):37543. doi: 10.1038/s41598-025-23820-3.
Acromegaly
Sun Y, Lu D, Gao J.Drug Discov Ther. 2025 Oct 29. doi: 10.5582/ddt.2025.01109. Online ahead of print.
Stanciu M, Cătană A, Ristea RP, Tanasescu D, Carsote M, Popa FL, Lebădă IC.Diagnostics (Basel). 2025 Oct 17;15(20):2623. doi: 10.3390/diagnostics15202623.
Cushing’s
Three Cases of Ectopic, Cyclic Cushing Syndrome: A New Square Wave Variant.
Martinez-Gil M, Tshimbombu TN, Li Yi Ang Y, Rodriguez MC, Yuen KCJ.JCEM Case Rep. 2025 Oct 28;3(12):luaf176. doi: 10.1210/jcemcr/luaf176. eCollection 2025 Dec.
Selective Hippocampal Subfield Atrophy Mediates Cognitive Decline in Cushing’s Disease.
Feng Z, Zhou T, Yan X, He K, Liu H, Yu X, Lu R, Ma Z, Yu X, Zhang Y.Brain Behav. 2025 Nov;15(11):e71030. doi: 10.1002/brb3.71030.
Hormonal health
Pellegrini B, Cantaluppi V, Aimaretti G, Ferraresso M, Romagnoli J, Silvestre C, Comai G, Maggiore U, Leone F, Greco R, Maggiolini M, Provenzano M, Zaza G; Joint Committee of the Italian Society of Organ Transplantation and the Italian Society of Nephrology.J Endocrinol Invest. 2025 Oct 29. doi: 10.1007/s40618-025-02741-y. 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.
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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