“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 August 2026

    Secretary of Defense concerned about low testosterone in the military

    Secretary of Defense Pete Hegseth is mandating testing of male troops over age 30 for low testosterone and will offer testosterone replacement therapy. Many endocrinologists say this approach is problematic. Read more: https://arstechnica.com/health/2026/07/hegseth-wants-a-high-t-military-doctors-call-it-a-clinical-minefield/

    The Endocrine Society issue statement in the wake of Hegseth’s announcement:

    https://www.endocrine.org/news-and-advocacy/news-room/2026/statement-on-testosterone-replacement-therapy

    Pituitary story: Lionel Messi

    Soccer mega-star Lionel Messi was diagnosed with growth hormone deficiency as a child. Read more: https://www.msn.com/en-in/health/other/lionel-messi-overcame-growth-hormone-deficiency-as-a-child-a-condition-that-almost-derailed-his-football-dream/ar-AA280JJc

    Vision issues in acromegaly

    PNA member Dr. Maria Fleseriu is featured in an article in EverydayHealth.com about how acromegaly can affect a patient’s eyesight. Read more: https://www.everydayhealth.com/hormones-metabolic-disorders/how-acromegaly-can-affect-your-eyesight/

    Delayed diagnosis of Cushing’s in Japanese children

    An article in Cushing’s Disease News looks at a study that found Japanese children often face delays in diagnosis of Cushing’s disease, but many are successfully treated with surgery. Read more: https://cushingsdiseasenews.com/news/japanese-children-face-long-delays-cushings-disease-diagnosis/

    Pituitary story: Idaho teen battles germinoma near pituitary gland

    Delayed puberty and growth, combined with diabetes insipidus, led doctors to diagnose a 16-year-old boy from Idaho with a germ cell tumor near his pituitary gland. Read more: https://www.fredhutch.org/en/news/blog/2026/07/college-bound-16-year-old-didnt-let-germinoma-get-him-down.html

    Pituitary surgery story: Transsphenoidal surgery at Walter Reed

    A story in the Times of India highlights the work of an Indian American pituitary surgeon at Walter Reed National Military Medical Center in Bethesda, Maryland: Major Jagatkumar “J.” Patel, and his colleague Army neurosurgeon Lt. Col. Charles Miller.  Read more: https://timesofindia.indiatimes.com/health/indian-american-army-surgeon-removes-golf-ball-sized-brain-tumour-through-a-patients-nose-avoiding-open-skull-surgery/amp_articleshow/132781973.cms

    Experts play down the idea of “male menopause”

    An article in the Kansas City Star explains that men do not experience a sharp drop-off in hormones in the same way women do; the process is more gradual. Read more: https://www.kansascity.com/living/article316673842.html

    The same reporter looks at testosterone replacement therapy in an article in the Miami Herald: https://www.miamiherald.com/living/article316675898.html

    Research Articles

    Research Articles August 2026

    Pituitary tumors

    Predicting hormonal deterioration following transsphenoidal surgery for non-functioning pituitary adenomas: A systematic review and meta-analysis.

    Ameen D, ElSabban Y, Kalaitzoglou D, Shapey J, Barazi S, Thomas N, Aylwin S, Maratos E.Endocrine. 2026 Aug 1;91(1):243. doi: 10.1007/s12020-026-04712-6.

     

    Effect of sellar and parasellar brain tumors on retinal thickness and visual fields: A cross-sectional comparative study.

    Kasireddy HD, Sahu V, Sharma A, Kumar A, Shrivastava S.Indian J Ophthalmol. 2026 Aug 1;74(8):1185-1190. doi: 10.4103/IJO.IJO_215_26. Epub 2026 Jul 31.


    Case report of two growth hormone-secreting invasive pituitary adenomas and literature review.

    Zhou J, Wen J, Leng H, Yi J.Arch Med Sci. 2026 Jun 23;22(3):1926-1931. doi: 10.5114/aoms/224312. eCollection 2026.


    Statistical Geometric Morphometric Shape Analysis of Ventricular Shape Changes in Giant Pituitary Adenomas Invading the Third Ventricle.

    Altunyuva O, Balcin N, Ocakoglu G, Taskapilioglu MO, Yilmazlar S.Turk Neurosurg. 2026;36(4):509-516. doi: 10.5137/1019-5149.JTN.49331-25.2.

     

    Personalized prediction of local control after stereotactic radiosurgery for craniopharyngioma: a multicenter machine learning survival model.

    Reyes JS, Hadjipanayis CG, Bernstein K, Speckter H, Gonzalez I, Chytka T, Liscak R, Bowden GN, Sumi T, Narita K, Kano H, Martínez-Moreno N, Martínez-Álvarez R, Picozzi P, Franzini A, Tripathi M, Rai A, Kumar N, Douri K, Mathieu D, Dono A, Amezquita-Contreras C, Blanco AI, Esquenazi Y, Tos SM, Mantziaris G, Peker S, Samanci Y, Duzkalir AH, Meng Y, Sheehan JP, Kondziolka D, Lunsford LD, Niranjan A.J Neurooncol. 2026 Jul 31;179(1):22. doi: 10.1007/s11060-026-05736-8.

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

     

    Cushing’s

    Annexin A1 as a diagnostic biomarker for cyclic Cushing disease.

    Rao Z, Wu L, Jiang L, Su T, Cao Y, Lin S, He X, Ye Y, Ning G, Wang W, Zhang C.iScience. 2026 Jul 22;29(8):116907. doi: 10.1016/j.isci.2026.116907. eCollection 2026 Aug 21.

     

    MRI predictive value for adenoma detection in Cushing’s disease and reader dependence: a multi-observer study.

    Constanthin PE, Ferrière A, Sanchez-Gallardo F, Nunes ML, Berge J, Engelhardt J.J Neurosurg. 2026 Jul 31:1-9. doi: 10.3171/2026.2.JNS252331. Online ahead of print.

     


    Baseline biochemical evaluation for etiologic differentiation in ACTH-dependent Cushing’s syndrome: machine learning and composite score analysis in a multicenter cohort of 566 patients.

    Detomas M, Prada Salcedo JP, Altieri B, Stüfchen I, Nasi-Kordhishti I, Wolfsberger S, Losa M, Quinkler M, Kimpel O, Vila G, Honegger JB, Rubinstein G, Fassnacht M, Deutschbein T.Eur J Endocrinol. 2026 Jul 31:lvag141. doi: 10.1093/ejendo/lvag141. Online ahead of print.

     

    Acromegaly

     

    Assessment of nurses’ knowledge and awareness of acromegaly in a high-volume tertiary center: a cross-sectional study.

    Genc B, Polat SB, Koc A, Ersoy R.Pituitary. 2026 Jul 31;29(4):136. doi: 10.1007/s11102-026-01737-y.

     

    Hormonal health

     

    Pituitary Apoplexy Without Chiasmal Compression Presenting With Radiographic Oculomotor Nerve Compression in a Prolactinoma: A Case Report.

    Holz EA, Imran M, Reyes N, Izquierdo-Pretel G.Cureus. 2026 Jun 30;18(6):e111830. doi: 10.7759/cureus.111830. eCollection 2026 Jun.

     

     

    Progressive Cerebellar Dysfunction, Pituitary Insufficiency, and Severe Skeletal Fragility in Adult Survivorship of Childhood Multisystem Langerhans Cell Histiocytosis: A Case Report.

    Alnahar S, Senjab A, Gharib S, Gharib Z, Hadid L.Clin Case Rep. 2026 Jul 29;14(8):e73261. doi: 10.1002/ccr3.73261. eCollection 2026 Aug.


    A Novel LHX3 Variant Associated With Combined Pituitary Hormone Deficiency in an Indian Kindred.

    Palaniappan S, Sridhar S, Thasarathan S, Shanmugam D, Dutta P.Cureus. 2026 Jun 29;18(6):e111778. doi: 10.7759/cureus.111778. eCollection 2026 Jun.

     

     

    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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