“Give a man health and a course to steer, and he’ll never stop to trouble about whether he’s happy or not.”

– George Bernard Shaw

 

PNA Spotlight: Dr. Paul A. Gardner

This month the PNA Spotlight focuses on Dr. Paul A. Gardner. 

Paul A. Gardner, MD, joined the faculty at the University of Pittsburgh Department of Neurological Surgery in 2008 after completing his residency and fellowship training at the University of Pittsburgh. He completed his undergraduate studies at Florida State University, majoring in biochemistry, and received his medical degree from the University of Pittsburgh School of Medicine.

Dr. Gardner completed a two-year fellowship in endoscopic endonasal pituitary and endoscopic and open skull base surgery. His research has focused on evaluating patient outcomes following these surgeries and more recently on genomic and molecular analysis of skull base tumors. Dr. Gardner has been the neurosurgical director of the Center for Cranial Base Surgery at the University of Pittsburgh Medical Center since April of 2008 and, along with Carl Snyderman, MD, of the University of Pittsburgh Department of Ophthalmology, leads a renowned course on endoscopic endonasal surgery three times a year.

His answers are below:

PNA Medical Corner: Artificial intelligence and pituitary surgery

The PNA Medical Corner this month features an article co-authored by neurosurgeon Aaron Cohen-Gadol of Indiana University, a longtime member of the PNA. They conclude that A-I and machine learning will improve preoperative planning and surgical strategies in pituitary surgery, but points out challenges on multiple fronts.

Current status of artificial intelligence technologies in pituitary adenoma surgery: a scoping review

Abstract

Purpose: Pituitary adenoma surgery is a complex procedure due to critical adjacent neurovascular structures, variations in size and extensions of the lesions, and potential hormonal imbalances. The integration of artificial intelligence (AI) and machine learning (ML) has demonstrated considerable potential in assisting neurosurgeons in decision-making, optimizing surgical outcomes, and providing real-time feedback.

    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


    Interrogation of the cellular hierarchies reveals neoplastic evolution and therapeutic vulnerability in craniopharyngioma.

    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.

     

    Unusual Dual Brain Tumor Morphologies in an MEN1 Patient: A Case Report of Diagnostic Challenges and Methylation Insights.

    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

    Combined Use of Diffusion- and Perfusion-Weighted Magnetic Resonance Imaging in the Differential Diagnosis of Sellar Tumors: A Single-Centre Experience.

    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.


    A swarm intelligence-driven hybrid framework for brain tumor classification with enhanced deep features.

    Yonar A.Sci Rep. 2025 Oct 28;15(1):37543. doi: 10.1038/s41598-025-23820-3.

     

    Acromegaly

    Paltusotine: The first selective nonpeptide agonist of somatostatin receptor 2 (SSTR2) for the treatment of acromegaly.

    Sun Y, Lu D, Gao J.Drug Discov Ther. 2025 Oct 29. doi: 10.5582/ddt.2025.01109. Online ahead of print.

     

    Hematological Malignancy in a Hypophysectomised Acromegalic Patient Under 4-Year Therapy with Somatostatin Analogues: From a Rib Lump Underlying Bone Plasmatocytoma Features to Multiple Myeloma.

    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

     

    Awareness of post-transplant endocrine disorders among kidney transplant clinicians: results of an Italian survey.

    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.

    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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