“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 February 2024

    Touch Endo Newsletter

    The latest newsletter from Touch Endo covers a range of topics, including research on diagnosing pituitary tumors, treating diabetes, lessening symptoms of menopause, and promoting liver health. Read more here: 

     

    Banned Growth Hormone Linked to Transmission of Alzheimer’s

    A study published in the Journal Nature looks at the prevalence of Alzheimer’s disease in patients injected with cadaver-derived pituitary growth hormone, which was banned in 1985 after some patients developed Creuztfeldt-Jakob disease. It is the first documentation of the transmissibility of Alzheimer’s  Read more here:

    Here is an article that explains why this is unlikely to happen again.  Read more here:

     

    U.K. Soccer Player Battles Acromegaly

    An article in the Leicester Mercury tells the story of Tom Mayor, a semi-pro goalkeeper diagnosed with acromegaly.  Read more here:

     

    Can A-I Help Write Medical Case Reports?

    An article in on Cureus.com presents a case study of a child with Rathke’s Cleft Cyst, written using artificial intelligence, in this case ChatGPT. The author concludes that ChatGPT produced some helpful tables, it “has limitations in answering questions, particularly in providing specific data and addressing individual cases.” Read more here:

    Research Articles

    February 2024 Research Articles

    Pituitary Tumors

    Functional gonadotroph pituitary adenoma: A case report.

    Prolactinoma and Adenomyosis – More than Meets the Eye: A Case Report.

    Brain tumor detection from images and comparison with transfer learning methods and 3-layer CNN.

    Resistance to thyroid hormone and non-functioning pituitary microadenoma in a 13-year-old boy with a mutation in THRB

    Identification of HSPD1 as a novel invasive biomarker associated with mitophagy in pituitary adenomas.

    Clinical and Pathological Features of Pit1/SF1 Multilineage Pituitary Neuroendocrine Tumor.

    Pituitary Surgery

    The risk analysis index demonstrates superior discriminative ability in predicting extended length of stay in pituitary adenoma resection patients when compared to the 5-point modified frailty index.

    Cushings

    Recurrent Cushing’s Disease Caused by a TPIT-Lineage Densely Granulated Corticotroph Pituitary Neuroendocrine Tumor: A Case Report.

    Back to the Future: Dynamic Contrast Enhanced Photon Counting Detector CT for the Detection of Pituitary Adenoma in Cushing Disease.

     

    Panhypopituitarism

    Pituitary Abscess Causing Panhypopituitarism in a Patient With Neurobrucellosis: Case Report.

     

    Pituitary Hypophysitis

    Pituitary hypophysitis in granulomatosis with polyangiitis (GPA): a case series.

     

    Pituitary Cancer

    Hepatocellular carcinoma metastatic to the pituitary gland without an identifiable primary lesion.

     

    Hormonal Health

    The adverse role of endocrine disrupting chemicals in the reproductive system.

    Changes in the European Union definition for endocrine disruptors: how many molecules remain a cause for concern? The example of crop protection products used in agriculture in France in the six last decades.

    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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