News Articles February 2022

Written on 04 February 2022.

News Articles May 2025

Pituitary journey: woman learns to slow down while facing melanoma, pituitary inflammation

Blogger Amanda Goodwin is a hard-charging businesswoman, who was forced to slow down and “embrace the sick” as she battled melanoma in her lungs, liver and brain, and suffered from inflammation of the pituitary. Read more here: https://substack.com/home/post/p-156259244?utm_campaign=post&utm_medium=web

 

Study: Cushing’s patients develop cataracts at younger ages

An article in Cushing’s Disease News examines a study published in Graefe’s Archive for Clinical and Experimental Ophthalmology, that finds that Cushing’s patients are at higher risk of developing cataracts at a younger age compared to non-Cushing’s patients.  They developed them at an average age of 48.1. Patients with Cushing’s Syndrome “being 34% more likely to develop cataracts than the general population. For those with Cushing’s disease, the risk was 39% higher.” Read more: https://cushingsdiseasenews.com/news/cushings-patients-higher-risk-developing-cataracts-younger-age/

 

Pituitary Journey: British celebrity astrologer recounts battle with pituitary tumor

Russell Grant, a celebrity astrologer in the U.K. who competed on the show “Strictly Come Dancing” recounts his battle with a pituitary tumor, diabetes, and now vision issues. Read more: https://tinyurl.com/44zujvkm

Houston Hospital gets $2 million in donations for pituitary research

Houston Methodist hospital announced it has commitments to receive 2 million dollars to support its Kenneth R. Peak Brain & Pituitary Treatment Center. $1.5 million comes from the Henry J.N. Taub Foundation and is paired with an anonymous $500,000 donation. Read more: https://philanthropynewsdigest.org/news/houston-methodist-receives-1.5-million-for-brain-pituitary-research

PNA Highlights May 2025

“The greatest wealth is health.”

– Virgil

PNA Spotlight: Dr. Juan Fernandez-Miranda

This month, the PNA Spotlight shines on Dr. Juan Fernandez-Miranda, a Professor of Neurosurgery and Surgical Director of the Stanford Brain Tumor, Skull Base, and Pituitary Centers.  He did his neurosurgery residency at La Paz University Hospital in Madrid. He then spent two years in fellowship training in microsurgical neuroanatomy at the University of Florida. He completed clinical training in cerebrovascular surgery at the University of Virginia and skull base surgery at the University of Pittsburgh Medical Center, where he spent 10 years before being recruited to Stanford University.  Dr. Fernandez-Miranda answered a few questions from PNA; the interview is edited for clarity.

 What would you like people to know about your neurosurgical practice?

Well, specifically for pituitary tumors, my practice is very unique in the sense that it’s highly specialized. 95% of what I do are pituitary and skull base tumors. I‘s very rare to have a practice with this level of focus. I do complex tumors in the pituitary and surrounding areas  and patients come from all over the country and internationally because of my expertise. I’ve been doing this since 2008 and we currently perform over 300 such operations every year. My background is unique because I spent years doing anatomical research and am still doing so.  We continue to make contributions to the study of the anatomy of the pituitary area – the sellar and parasellar region. Specifically, my expertise is with complex pituitary tumors that invade the cavernous sinus. That’s why people travel to see me for the most part, because they have tumors that are difficult to operate on.  We have developed techniques that allow for better surgical resection, and therefore better outcomes.  This is critically important for functional tumors, like patients who have acromegaly or Cushing’s disease or prolactinomas. It is also important for tumors that are non-functioning, because these tumors require good resection, otherwise they continue growing and they cause trouble.   We publish our outcomes routinely and often present our results at national and international conferences. We also produce anatomical papers, technical papers, to teach others how to how to do these operations.

Read More Here

 

New Advances For Treating Complex Pituitary Tumors

Pituitary tumors can vary widely in severity, with some requiring surgical intervention. While certain pituitary tumors are more straightforward to remove, those that extend beyond the medial wall of the cavernous sinus (MWCS) are considered complex. A delicate region near the pituitary gland, the MWCS contains critical structures like cranial nerves and the carotid artery, which present additional surgical challenges.

Historically, surgeons avoided entering the cavernous sinus due to the risk of damaging these vital structures, but new advancements have made it possible to remove tumors more effectively and safely. Innovative surgical techniques, such as endoscopic endonasal approaches, are allowing neurosurgeons to navigate these delicate areas with greater precision and confidence than ever before.

Neurosurgeon Dr. Kaisorn Chaichana, who has performed well over 100 such procedures at Mayo Clinic in Jacksonville, Florida, says, “The latest advancements in pituitary surgery are driven by improved camera optics. Angled scopes now let us see around corners, helping us distinguish the pituitary gland from the tumor with far greater precision than traditional microscopes. Doppler and ultrasound also allow us to identify critical structures like the carotid artery, ensuring safer, more complete tumor removal.”

If a tumor that extends into the MWCS is not removed, it may continue producing excessive hormones, leaving patients with persistent symptoms. “It’s almost as if they didn’t have surgery at all because there’s still that tumor there causing that hormonal imbalance. That’s why achieving total removal is so critical for long-term success,” said Dr. Chaichana.

Although the procedure is not entirely new, widespread adoption is relatively recent, and only a few institutions perform this surgery regularly. The complexity of the procedure requires expert knowledge of the surrounding anatomy, as well as careful coordination between neurosurgeons, ear, nose, and throat (ENT) specialists, and post-operative care led by an endocrinologist. “The cavernous sinus is an area a lot of surgeons aren’t comfortable with, and that’s why we specialize in that surgery here,” added Dr. Chaichana. Mayo Clinic’s multidisciplinary approach has improved patient outcomes, allowing for safer tumor removal with reduced complications.

For patients with recurrent tumors or those initially deemed inoperable, re-evaluating surgical options at a specialized center may provide new hope. If the tumor is confined to one side of the carotid artery, surgeons can often achieve a complete resection. However, if it extends beyond this point, additional treatments such as radiation or medical therapy may be required.

Patients facing pituitary surgery should seek a neurosurgeon with experience in endoscopic techniques at a specialized facility with extensive expertise in pituitary tumor treatment.

Choosing the right surgical team can significantly impact outcomes, particularly for complex cases. While not all tumors require MWCS resection, for those that do, this approach offers a path to better surgical success and long-term remission. With ongoing advancements in pituitary surgery, more patients than ever have access to safer, more effective treatment options.

For more information or to request an appointment, please visit Pituitary Tumor Care – Mayo Clinic

 

Featured News and Updates

Research Articles

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)

Copyright © 2024 Pituitary Network Association All rights reserved.

Disclaimer: PNA does not engage in the practice of medicine. It is not a medical authority, nor does it claim to have medical expertise. In all cases, PNA recommends that you consult your own physician regarding any course of treatment or medication.

Our mailing address is:
Pituitary Network Association
P.O. Box 1958
Thousand Oaks, CA 91358
(805) 499-9973 Phone - (805) 480-0633 Fax
Email [email protected]

You are receiving this Newsletter because you have shown interest in receiving information about our activities.

If you do not want to receive any more emails from PNA, Unsubscribe.

May 2025 Research Articles

Pituitary Surgery

Indocyanine green fluorescence in endoscopic transsphenoidal resection of pituitary neuroendocrine tumors: a systematic review.

Olesrud I, Halvorsen IJ, Storaker MA, Heck A, Dahlberg D, Wiedmann MKH.Acta Neurochir (Wien). 2025 Mar 28;167(1):92. doi: 10.1007/s00701-025-06500-z.


Extended endoscopic endonasal approach for solid or predominantly solid third ventricle craniopharyngiomas complicated with obstructive hydrocephalus: a single-center experience of 27 patients.

Qiao N, Li C, Liu X, Song Y, Liang L, Zou Y, Lu P, Zhang Y, Gui S.Neurosurg Rev. 2025 Mar 26;48(1):325. doi: 10.1007/s10143-025-03486-1.

 

Transsphenoidal Surgery for Pituitary Neuroendocrine Tumours (PiTNETs) in a Tertiary Hospital: Are There Differences Between Young and Elderly Patients?

Borrego-Soriano I, Parra-Ramírez P, Martín-Rojas-Marcos P, Pérez-López C, García-Feijoo P, Álvarez-Escolá C.Clin Endocrinol (Oxf). 2025 Mar 24. doi: 10.1111/cen.15242. Online ahead of print.PMID: 40129236

 

Pituitary Tumors


Fungal Sinusitis Spreading to the Sellar Region Mimicking a Pituitary Tumor: Case Report and Literature Review.

Pekic Djurdjevic S, Arsic Arsenijevic V.J Fungi (Basel). 2025 Mar 19;11(3):233. doi: 10.3390/jof11030233.

 

Functional Transformation of a Corticotroph Pituitary Neuroendocrine Tumor 128 Months Following Primary Excision ? A Case Report.

Goyal-Honavar A, Abraham AP, Asha HS, Chacko G, Chacko AG.Turk Neurosurg. 2025;35(2):355-359. doi: 10.5137/1019-5149.JTN.44912-23.2

 

Genetic Characterization of Turkish Patients with Pituitary Neuroendocrine Tumors.

Alavanda C, Sonmez O, Geckinli BB, Bayrakli F, Guney AI.Turk Neurosurg. 2025;35(2):319-320. doi: 10.5137/1019-5149.JTN.45761-23.2.

 

 

Empty Sella

 

Relationship Between Radiological Features of Primary Empty or Primary Partial Empty Sella and Pituitary Hormone Levels.

Kałuża B, Furmanek M, Domański J, Żuk-Łapan A, Babula E, Poprawa I, Walecki J, Franek E.Biomedicines. 2025 Mar 15;13(3):722. doi: 10.3390/biomedicines13030722.

 

Acromegaly

 

Copeptin and Mid-Regional Proadrenomedullin Are Not Useful Biomarkers of Cardiometabolic Disease in Patients with Acromegaly-A Preliminary Study.

Strzelec M, Kubicka E, Kuliczkowska-Płaksej J, Kolačkov K, Janek Ł, Bolanowski M, Jawiarczyk-Przybyłowska A.Biomedicines. 2025 Mar 8;13(3):666. doi: 10.3390/biomedicines13030666.

 

Hypopituitarism


Identification of POU1F1 Variants in Vietnamese Patients with Combined Pituitary Hormone Deficiency.

Nguyen HT, Nguyen KN, Dien TM, Can TBN, Nguyen TTN, Lien NTK, Tung NV, Xuan NT, Tao NT, Nguyen NL, Tran VK, Mai TTC, Tran VA, Nguyen HH, Vu CD.Int J Mol Sci. 2025 Mar 7;26(6):2406. doi: 10.3390/ijms26062406.


Hypopituitarism: genetic, developmental, and acquired etiologies with a focus on the emerging concept of autoimmune hypophysitis.

Bando H, Urai S, Kanie K, Yamamoto M.Endocr J. 2025 Mar 27. doi: 10.1507/endocrj.EJ25-0035. Online ahead of print.

 

Hormonal Health

A Novel Missense Variant in LHX4 in Three Children with Multiple Pituitary Hormone Deficiency Belonging to Two Unrelated Families and Contribution of Additional GLI2 and IGFR1 Variant.

Santoro C, Aiello F, Farina A, Miraglia Del Giudice E, Pascarella F, Licenziati MR, Improda N, Piluso G, Torella A, Del Vecchio Blanco F, Cirillo M, Nigro V, Grandone A.Children (Basel). 2025 Mar 14;12(3):364. doi: 10.3390/children12030364.

 

Hyperprolactinemia is associated with height attainment within or above target height in adult patients with pituitary stalk interruption syndrome.

Wang Y, Mao J, Wang X, Nie M, Zhang J, Zhang W, Liu H, Xu Z, Wu X.Endocr Pract. 2025 Mar 25:S1530-891X(25)00095-3. doi: 10.1016/j.eprac.2025.03.010. Online ahead of print.

 

Multiple Endocrine Neoplasia Type 1 (MEN1) Syndrome Clinical Presentation and the Role of Newer Functional Imaging in the Diagnosis and Management: A Case Report.

Singh R, Goel SA, Singh JS, John DR, Suthar PP.Cureus. 2025 Feb 24;17(2):e79580. doi: 10.7759/cureus.79580. eCollection 2025 Feb.

 

PNA Spotlight: Dr. Juan Fernandez-Miranda

PNA Spotlight: Dr. Juan Fernandez-Miranda 

This month, the PNA Spotlight shines on Dr. Juan Fernandez-Miranda, a Professor of Neurosurgery and Surgical Director of the Stanford Brain Tumor, Skull Base, and Pituitary Centers. He did his neurosurgery residency at La Paz University Hospital in Madrid. He then spent two years in fellowship training in microsurgical neuroanatomy at the University of Florida. He completed clinical training in cerebrovascular surgery at the University of Virginia and skull base surgery at the University of Pittsburgh Medical Center, where he spent 10 years before being recruited to Stanford University. Dr. Fernandez-Miranda answered a few questions from PNA; the interview is edited for clarity.

What would you like people to know about your neurosurgical practice?
Well, specifically for pituitary tumors, my practice is very unique in the sense that it’s highly specialized. 95% of what I do are pituitary and skull base tumors. I’s very rare to have a practice with this level of focus. I do complex tumors in the pituitary and surrounding areas . and patients come from all over the country and internationally because of my expertise. I’ve been doing this since 2008 and we currently perform over 300 such operations every year. My background is unique because I spent years doing anatomical research and am still doing so. We continue to make contributions to the study of the anatomy of the pituitary area – the sellar and parasellar region. Specifically, my expertise is with complex pituitary tumors that invade the cavernous sinus. That’s why people travel to see me for the most part, because they have tumors that are difficult to operate on. We have developed techniques that allow for better surgical resection, and therefore better outcomes. This is critically important for functional tumors, like patients who have acromegaly or Cushing’s disease or prolactinomas. It is also important for tumors that are non-functioning, because these tumors require good resection, otherwise they continue growing and they cause trouble. We publish our outcomes routinely and often present our results at national and international conferences. We also produce anatomical papers, technical papers, to teach others how to how to do these operations.

Which techniques have you developed?
I work mostly in the area of the endoscopic endonasal approach. Specifically, we described techniques to do a stepwise resection of the medial wall of the cavernous sinus. Especially with functional tumors, relatively often, we find the tumor invading or embedded in that membrane. This was developed for Cushing’s disease years ago and was done with a microscope. But we studied it more systematically, and we expanded to other diseases. Our team developed techniques with the endoscope, which allows us to see better, so we can do better resection of the medial wall, and extend it to more pathologies. In addition to the resection of the medial wall, we described different compartments within the cavernous sinus. We described how to navigate within the cavernous sinus and remove the tumor from those areas, which is extremely important. Along with that, we described some unique concepts, like different patterns of medial wall invasion and tumors that can invade ligaments. We described ligaments that were not reported before within the cavernous sinus. These ligaments are important because they anchor the medial wall of the cavernous sinus. You need to disconnect these ligaments to remove the invaded medial wall. And we also study how these ligaments can be invaded by tumors. We continue doing research in these areas, studying better the ligamentous structures and the different compartments of the cavernous sinus. We continue our anatomical research with technical applications. In addition, we follow our patients and report their outcomes, so that we can do this very safely. This is very effective; my remission rates, generally speaking, are among the best you can find in the literature for acromegaly, Cushing’s disease, prolactinomas, even for non-functional adenomas. But at the same time, preserving a similar low rate of complications. So, we can do better without making the patients any worse. And that is why many patients travel to see me.

What is the next frontier in neurosurgery? What do you aim to improve or discover within the next five or 10 years?
Well, there are two routes there: the route of continuing the studies I’m doing, and to keep pushing on the boundaries of the surgical technique. Remission rates and good outcomes are at about 80 to 90%. That means there are still 10 to 20% of patients that have tumors that are too invasive, too difficult, that we cannot fully remove or cure. I think we can push techniques further to make these numbers a bit better, however, there is a limit there. There are some tumors that, even with the best possible technique, will not be curable. Therefore, there is a need for development of newer therapeutics, especially new drugs that can actually treat these tumors effectively. I think that pushing the boundaries of the surgical technique will continue improving patient outcomes. We are also working on highly complex cases, the 10-20% that we cannot fully cure, by doing a type of more hybrid operation. We are able to minimize the amount of tumor with surgery and then use adjuvant therapy, like radiosurgery, CyberKnife in particular, to then treat that residual tumor. And maybe we can help increase the number of patients that are cured or in remission. The preliminary data shows that that we can actually increase by five to ten percent the number of cases that are achieving remission. So, we’re getting closer, with the objective of curing them all.

What inspired you to choose your career path in neurosurgery? And then why did you choose a pituitary specialty?
I chose medicine because of an intellectual interest in how things work in the human body and mind. And I am drawn to the humanistic part of medicine, of being able to actually help people with what you do and have an impact. That is very important, and I got into surgery in particular because that is the most actionable of all medical disciplines. I would say surgery is the one that is the most actionable and where you can physically use your hands to heal people, so I found that very appealing. And neurosurgery, I think, is the highest intellectual and technical challenge because of the complexity of the brain and the skull base. I am interested in the skull base because it is the most intricate area in the head, where we access fascinating anatomy, presenting real challenges. I am always looking for a challenge to motivate myself, and I like to aim toward things that are difficult. The skull base is really, very difficult, because tumors get tangled in blood vessels, in cranial nerves, and are deeply located. These patients often have benign tumors that cause major health issues, which means that the work we are doing can really help and impact their lives. At the same time, if something goes wrong, the impact can be devastating. So, there is a lot to win, but also a lot to lose. Unfortunately, some patients with a malignant tumor will not be cured, no matter how well you do, because of the severity of the disease. But for the most part, these are benign tumors. They may have a very negative impact on the patient’s health, but they are not lethal. Therefore, you always have to temper what you do, and how you do it. It’s very important to be courageous, but you do need to have a very measured courage. You really need to know what you’re doing. What I’m doing seems very risky, but when you are well prepared, you can do very risky things with a very, very low risk profile. This is like when you see someone like Alex Honnold who climbs El Capitan in Yosemite with no ropes. That looks very risky to me, but someone like him has been training all his life to make it look easy. So, we do our best to make complex pituitary surgery look very easy. Even though it appears very risky, we can do it with very low morbidity.

Who have been your mentors?
I had several mentors. Professor Albert Rhoton is the reason why I came to the United States when I finished my training in Spain in 2005. He is widely considered to be the father of microsurgical neuroanatomy. His work has allowed us to do very precise micro-neurosurgery. He was a mentor to generations of neurosurgeons. His work is tremendously influential. Under him, I spent two years at the University of Florida studying in the laboratory, exclusively doing microsurgical neuroanatomy, to prepare myself for a better future surgical career. And believe it or not, that is something that the majority of neurosurgeons do not do as they rarely have spent any meaningful time in the laboratory training themselves. Because you are working within someone’s head, it makes the most sense to spend as much time as possible in the laboratory with human heads to familiarize yourself with it. That was very impactful for me. It allowed me to feel very confident doing surgery, shortening the learning curve because you become familiar with the environment you’re working in. There are many things you can only learn in the operating room, with years of experience, but there are some basic anatomical and technical concepts that you should first acquire in the laboratory, and those are essential to become confident and knowledgeable in the operating room.
When I moved to the University of Pittsburgh, I trained with the pioneering team on endoscopic endonasal surgery. Amin Kassam was the leading figure in the United States and he is my mentor on the endoscopic endonasal approach. He is phenomenally technically talented. He is very innovative, and he was a huge influence on me, along with the whole original Pittsburgh team: Gardner, Prevedello, Carrau, and Snyderman. In addition, I happened to be at the University of Virginia in 2007 when Ed Oldfield was starting his tenure at UVA. He’s regarded as the best pituitary surgeon for Cushing’s disease ever. Although he was not my mentor directly, I had the immense privilege of watching him operate every week for a year and enjoy his masterful operations. That deeply influenced me. He is the one who described how ACTH-secreting tumors can invade the medial wall of the cavernous sinus, demonstrating that it’s important to remove that wall. He’s the one who first did it, and I built a lot of my research and clinical practice upon that knowledge.

Is there anything else you’d like to convey about your work?
My patients know that I’m extremely dedicated to them. They often come to me with the most difficult tumors, sometimes after previous operations that have failed, always with the fear of going through another operation and end up with a complication like a stroke, or problems with the eyes. I’m here for them. I have dedicated my life to this career, to make the best possible outcome for my patients. And I plan on continuing to do my best in the operating room for them. There is no finish line. We continue improving.

What has been your involvement with PNA over the years?
I’ve been involved for many years, because I think it’s a good resource for patients, and it’s important that they have a place to go and to gather information, to get recommendations, to navigate the difficult process of diagnosis of a new pituitary tumor. And I’ve been doing educational activities, including a number of webinars over the years. The PNA is a great resource for patients. It highlights our work and shares it with the community at large.

 

 

 

 

PNA Highlights October 2024

“Your body holds deep wisdom. Trust in it. Learn from it. Nourish it. Watch your life transform and be healthy.”

– Bella Bleue 

PNA Spotlight: Dr. Yuval Eisenberg

This month the PNA Spotlight shines on Dr. Yuval Eisenberg.  Dr. Eisenberg graduated from Rush Medical College at Rush University Medical Center in 2009. He works in Chicago, IL and two other locations and specializes in internal medicine as well as endocrinology, diabetes & metabolism.    Dr. Eisenberg is also affiliated with the University of Illinois Hospital Health & Science Center.  He was kind enough to answer some of our questions:

 

What inspired you to choose your career path?

My career path was guided by my interaction with patients and my mentors. The highlight of my medical school training was helping to diagnose a young man suffering from multiple endocrine neoplasia type 1 (MEN1), a rare genetic disorder causing multiple tumors, including a pituitary adenoma. Listening to his concerns and thinking outside the box, I helped provide him with the correct diagnosis and treatment plan – and started my journey into endocrinology. I have been fortunate to work with excellent clinician-educators in my career. Learning about and observing the care of patients with endocrine-related problems was fascinating and rewarding. The farther I got in my training, the more I realized that endocrinology was my passion and that patients with pituitary disorders would be my sub-focus. Patients with pituitary disease are a unique population who are in need of education, support and reassurance at diagnosis – and they often require long-term follow-up. This allows for time to develop a bond of trust; an aspect of medical practice I thoroughly enjoy.

Read More Here

 

Safeguarding the nose during pituitary tumor surgery

Pituitary tumors are typically removed through the nose during endoscopic transnasal transsphenoidal surgery. Although minimally invasive, that approach requires expertise to minimize surgical trauma to the nose. Fortunately, surgeons are using new techniques that help safeguard the nose and maximize patients’ quality of life after surgery.

“The tendency now is to be less invasive in the approach through the nose,” explains Dr. Carlos D. Pinheiro Neto, a Mayo Clinic ENT/head and neck surgeon. “A very aggressive approach can cause chronic nasal crusting and infections, scabbing, decreased sense of smell and taste, and changes in the nose’s appearance.”

In endoscopic transnasal transsphenoidal surgery, a small surgical camera and surgical instruments are placed through the nostrils to access the tumor through the sinuses. Mayo Clinic was among the first institutions to extensively research the approach. As initially developed, the procedure involved extensive nasal resection.

“The idea was to create a maximum opening of the sinuses to allow neurosurgeons to reach and remove the tumor from the skull base,” Dr. Pinheiro Neto says. “The nasal physiology and sinus symptoms after the surgery were not a priority — the nose was just a corridor to the tumor.”

Now, Dr. Pinheiro Neto is pioneering surgical techniques that minimize resection of the nasal and sinus structures. One involves leaving intact the middle turbinate, which plays important roles in nasal airflow, warming and filtering air to the lungs, and smelling. Another is using a nasal-floor graft to provide a seal between the nose and brain after tumor removal. The standard procedure when cerebrospinal fluid leaks during surgery involves a nasal septal flap created from the septum — the tissue that separates the nostrils’ two airways.

“Nasal graft is much better for patients. It avoids the exposure of the nasal septum cartilage, so there is less crusting and faster healing,” Dr. Pinheiro-Neto says. “Nasal septal flaps can also cause a structural collapse in the nasal bridge and increase the risk of septal perforations. Since changing our paradigm from nasal septal flap for pituitary surgery, our leak rate is 0.1%.”

The new techniques are based on research conducted in Mayo Clinic’s anatomy laboratory. Those lessons are translated to the operating room, where ENT/head and neck surgeons routinely work alongside neurosurgeons to remove pituitary tumors.

“That research has allowed us to achieve the same level of tumor resection and treatment outcomes, but with fewer complications,” Dr. Pinheiro-Nato says. “With time and experience, we have realized it’s possible to preserve most of the nose and still get good space in the back of the sinus for tumor removal.

“This is about improving patients’ quality of life,” Dr. Pinheiro-Neto says. “They can have a nasal procedure but after a few weeks of healing, the nose and nasal physiology, and the sinuses, are as good as ever before.”

Stanford Hosts Pituitary Patient Education Day

Stanford University invites the public to their free pituitary patient education day, to be held both in-person and via zoom on Saturday November 9th, 2024. The event will run from 8am-5pm and will take place in the Assembly Hall at Stanford Hospital.

The course co-directors include neurosurgeon Juan C. Fernandez-Miranda, MD (a longtime member of the PNA), and endocrinologist Julia Chang, MD. Topics to be discussed include the function of the pituitary gland, endonasal endoscopic surgery, cavernous sinus surgery, radiotherapy, Cushing’s, acromegaly, prolactinoma and more.

Click To Sign Up Here

Featured News and Updates

Research Articles

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)

Copyright © 2024 Pituitary Network Association All rights reserved.

Disclaimer: PNA does not engage in the practice of medicine. It is not a medical authority, nor does it claim to have medical expertise. In all cases, PNA recommends that you consult your own physician regarding any course of treatment or medication.

Our mailing address is:
Pituitary Network Association
P.O. Box 1958
Thousand Oaks, CA 91358
(805) 499-9973 Phone - (805) 480-0633 Fax
Email [email protected]

You are receiving this Newsletter because you have shown interest in receiving information about our activities.

If you do not want to receive any more emails from PNA, Unsubscribe.

News Articles October 2024

New acromegaly drug on the horizon

A new drug for treatment and long-term maintenance therapy for acromegaly is now on the horizon. Crinetics Pharmaceuticals recently submitted its first new drug application (NDA) to the U.S. Food and Drug Administration for paltusotine, which is a once-daily oral selectively-targeted somatostatin receptor type 2 nonpeptide agonist.

Crinetics says researchers used data from from 18 clinical trials in the application, including two Phase 3 trials that evaluated paltusotine for acromegaly in medically untreated and treated patients.   Patients tolerated the treatment well, the medication achieved biochemical control by maintaining IGF-1 levels and improved patients’ symptoms compared to placebo.   The company says it expects to hear back from the FDA by December.

Paltusotine, is the first drug of its type to complete Phase 3 clinical development for acromegaly and is now in Phase 2 clinical development for carcinoid syndrome associated with neuroendocrine tumors.  Read the company’s press release here. 

 

Can machine learning to predict hormone deficiency after pituitary surgery?

A study featured on Nature.com used machine learning algorithms to predict whether patients would develop arginine vasopressin deficiency after transsphenoidal surgery to remove a pituitary adenoma. Read more here: https://www.nature.com/articles/s41598-024-72486-w

 

Pituitary apoplexy strikes groom on wedding day

An article in People.com tells the story of a groom in England who had to leave his wedding reception early due to a severe headache – one that turned out to be a hemorrhaging pituitary tumor. Read more here: https://people.com/groom-migraine-wedding-day-tumor-popped-8718083

 

Researchers try to make synthetic oxytocin for pain relief

An article in the Focus.news looks at efforts to replicate the hormone oxytocin in the lab – in an effort to develop a painkiller that would be safer than opioids. Read more here: https://www.thefocus.news/lifestyle/scientists-are-hoping-to-replicate-the-cuddle-hormone-for-healthy-long-term-pain-relief/

PNA Spotlight: Dr. Leena Shahla

This month the PNA Spotlight focuses on endocrinologist Dr. Leena Shahla, director of the Duke Pituitary Center, part of Duke Health in Durham, North Carolina.  The program is listed by the PNA as a center of pituitary excellence. Dr. Shahla graduated medical school at Al-Baath University (in Homs, Syria), did her residency in internal medicine at St. Joseph’s at New York Medical College, and completed a fellowship in endocrinology at the University of Massachusetts Medical School. Her pituitary focus has grown significantly over the years.   She initiated the pituitary tumor board at the University of Florida, Jacksonville, and later built the pituitary clinic at the University of Arizona, Phoenix. She arrived at Duke this past July.  Dr. Shahla was kind enough to answer a few questions from the PNA. Below is the conversation.

 

Please tell us about your work at Duke.

At Duke, I am the neuroendocrinologist and medical director of Duke Pituitary Center. Our multidisciplinary team includes specialists in neurosurgery, neuro-ophthalmology, ENTs, neuro-oncology, and neuro-radiology.  We run a multi-disciplinary clinic. When patients visit for evaluation, they often start with visual field testing, followed by appointments with me and one of the neurosurgeons, all in one place. We all collaborate closely behind the scenes to make the best plan for each patient.

What inspired you to choose this career path?

My interest in hormones and their role in regulating various physiological systems led me to specialize in endocrinology. And then, as I realized the significant impact of the pituitary on the endocrine system, I found the challenge of diagnosing and treating pituitary conditions fascinating, much like solving a complex puzzle. So ultimately, that inspired me to specialize in pituitary disorders.

What is the primary focus of your work or research?

We’re working on a study on the link between hypogonadism and prolactinoma. We are also going to be looking into early diagnosis of Cushing’s and acromegaly.

How has endocrinology evolved since you got into it, and where do you think it’s going?

Medicine today is more advanced than ever.  Especially in my specialty, there have been advancements in pituitary-focused diagnostic tests and new treatments continue to emerge. This progress is especially beneficial for complex cases that previously had limited treatment options. The field is moving forward with studies and clinical trials underway. Cushing’s and acromegaly are rare diseases and often leave patients suffering for years before diagnosis. However, with greater public awareness and improved testing, patients are being diagnosed earlier.

What should patients know about endocrinology? What needs more awareness?

Cushing’s Syndrome and acromegaly deserve more awareness, as many patients go undiagnosed for long periods. Not all cases present with obvious symptoms making it crucial for primary care physicians and other providers to recognize early signs. When patients are diagnosed in advanced stages, treatment becomes more challenging. Raising awareness can guide physicians to screen for Cushing’s syndrome and acromegaly or refer patients to endocrinology. This proactive approach can help us identify, diagnose, and treat patients sooner.

 

What are some of the signs that doctors and patients should be looking for, for acromegaly and Cushing’s?

Both patients and providers should be aware of certain signs and symptoms, although they can be subtle or develop gradually.

For Cushing’s, signs could be unexplained weight gain, easy bruising, muscle weakness, mood changes (anxiety, depression, irritability), uncontrolled diabetes, or hypertension.

For acromegaly, some of signs are facial changes, hand and feet growth (increased ring or shoe size), joint pain and swelling, tingling in hands, jaw changes or pain, and widening of spaces between the teeth.

Early detection of these signs combined with diagnostic tests can help lead to timely intervention and management

What would you like to convey about yourself to your patients?

I believe that the doctor-patient relationship is built on communication, empathy, and trust. I am thorough in my approach, and when I meet patients, especially for the first time, I prioritize listening to their concerns, making sure I answer their questions and explain their conditions clearly so they understand. And I involve them actively in the decision-making process.

Empathy is essential, especially during the diagnosis and early stages of treatment before patients start feeling better. They need support, hand-holding, and understanding because they are often struggling physically, mentally, and emotionally. It is important to listen to their concerns patiently and guide them without getting frustrated. While we may not be able to cure everything, we can keep the disease very well-controlled, allowing them to feel better and supported.

What made you want to get involved with the PNA?

I always wanted to be involved with the PNA because pituitary disorders are not that common, and this group provides invaluable support to patients. My goal is to contribute as much as possible to help patients and community providers recognize the disease early.  Patients must be referred to centers with the right resources for diagnosis and treatment. At the end of the day, we all care deeply about our patients’ well-being.

 

 

 

PNA Highlights October 2024

“Your body holds deep wisdom. Trust in it. Learn from it. Nourish it. Watch your life transform and be healthy.”

– Bella Bleue 

PNA Spotlight: Dr. Yuval Eisenberg

This month the PNA Spotlight shines on Dr. Yuval Eisenberg.  Dr. Eisenberg graduated from Rush Medical College at Rush University Medical Center in 2009. He works in Chicago, IL and two other locations and specializes in internal medicine as well as endocrinology, diabetes & metabolism. Dr. Eisenberg is also affiliated with the University of Illinois Hospital Health & Science Center.  He was kind enough to answer some of our questions:

 

What inspired you to choose your career path?

My career path was guided by my interaction with patients and my mentors. The highlight of my medical school training was helping to diagnose a young man suffering from multiple endocrine neoplasia type 1 (MEN1), a rare genetic disorder causing multiple tumors, including a pituitary adenoma. Listening to his concerns and thinking outside the box, I helped provide him with the correct diagnosis and treatment plan – and started my journey into endocrinology. I have been fortunate to work with excellent clinician-educators in my career. Learning about and observing the care of patients with endocrine-related problems was fascinating and rewarding. The farther I got in my training, the more I realized that endocrinology was my passion and that patients with pituitary disorders would be my sub-focus. Patients with pituitary disease are a unique population who are in need of education, support and reassurance at diagnosis – and they often require long-term follow-up. This allows for time to develop a bond of trust; an aspect of medical practice I thoroughly enjoy.

Read More Here

 

Safeguarding the nose during pituitary tumor surgery

Pituitary tumors are typically removed through the nose during endoscopic transnasal transsphenoidal surgery. Although minimally invasive, that approach requires expertise to minimize surgical trauma to the nose. Fortunately, surgeons are using new techniques that help safeguard the nose and maximize patients’ quality of life after surgery.

“The tendency now is to be less invasive in the approach through the nose,” explains Dr. Carlos D. Pinheiro Neto, a Mayo Clinic ENT/head and neck surgeon. “A very aggressive approach can cause chronic nasal crusting and infections, scabbing, decreased sense of smell and taste, and changes in the nose’s appearance.”

In endoscopic transnasal transsphenoidal surgery, a small surgical camera and surgical instruments are placed through the nostrils to access the tumor through the sinuses. Mayo Clinic was among the first institutions to extensively research the approach. As initially developed, the procedure involved extensive nasal resection.

“The idea was to create a maximum opening of the sinuses to allow neurosurgeons to reach and remove the tumor from the skull base,” Dr. Pinheiro Neto says. “The nasal physiology and sinus symptoms after the surgery were not a priority — the nose was just a corridor to the tumor.”

Now, Dr. Pinheiro Neto is pioneering surgical techniques that minimize resection of the nasal and sinus structures. One involves leaving intact the middle turbinate, which plays important roles in nasal airflow, warming and filtering air to the lungs, and smelling. Another is using a nasal-floor graft to provide a seal between the nose and brain after tumor removal. The standard procedure when cerebrospinal fluid leaks during surgery involves a nasal septal flap created from the septum — the tissue that separates the nostrils’ two airways.

“Nasal graft is much better for patients. It avoids the exposure of the nasal septum cartilage, so there is less crusting and faster healing,” Dr. Pinheiro-Neto says. “Nasal septal flaps can also cause a structural collapse in the nasal bridge and increase the risk of septal perforations. Since changing our paradigm from nasal septal flap for pituitary surgery, our leak rate is 0.1%.”

The new techniques are based on research conducted in Mayo Clinic’s anatomy laboratory. Those lessons are translated to the operating room, where ENT/head and neck surgeons routinely work alongside neurosurgeons to remove pituitary tumors.

“That research has allowed us to achieve the same level of tumor resection and treatment outcomes, but with fewer complications,” Dr. Pinheiro-Nato says. “With time and experience, we have realized it’s possible to preserve most of the nose and still get good space in the back of the sinus for tumor removal.

“This is about improving patients’ quality of life,” Dr. Pinheiro-Neto says. “They can have a nasal procedure but after a few weeks of healing, the nose and nasal physiology, and the sinuses, are as good as ever before.”

Stanford Hosts Pituitary Patient Education Day

Stanford University invites the public to their free pituitary patient education day, to be held both in-person and via zoom on Saturday November 9th, 2024. The event will run from 8am-5pm and will take place in the Assembly Hall at Stanford Hospital.

The course co-directors include neurosurgeon Juan C. Fernandez-Miranda, MD (a longtime member of the PNA), and endocrinologist Julia Chang, MD. Topics to be discussed include the function of the pituitary gland, endonasal endoscopic surgery, cavernous sinus surgery, radiotherapy, Cushing’s, acromegaly, prolactinoma and more.

Click To Sign Up Here

Featured News and Updates

Research Articles

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)

Copyright © 2024 Pituitary Network Association All rights reserved.

Disclaimer: PNA does not engage in the practice of medicine. It is not a medical authority, nor does it claim to have medical expertise. In all cases, PNA recommends that you consult your own physician regarding any course of treatment or medication.

Our mailing address is:
Pituitary Network Association
P.O. Box 1958
Thousand Oaks, CA 91358
(805) 499-9973 Phone - (805) 480-0633 Fax
Email [email protected]

You are receiving this Newsletter because you have shown interest in receiving information about our activities.

If you do not want to receive any more emails from PNA, Unsubscribe.

October 2024 Research Articles

Pituitary Tumors

Investigating the relationship between cognitive impairment and brain white matter tracts using diffusion tensor imaging in patients with prolactinoma.

Duru M, Demir AN, Oz A, Kargin OA, Altunc AT, Demirel O, Arslan S, Kizilkilic O, Poyraz BC, Kadioglu P.J Endocrinol Invest. 2024 Oct 3. doi: 10.1007/s40618-024-02442-y. Online ahead of print.

 

Androgen Receptor Mediates Dopamine Agonist Resistance by Regulating Intracellular reactive oxygen species (ROS) in Prolactin-secreting Pituitary Adenoma.

Xu L, Lei Z, Wang Q, Jiang Q, Xing B, Li X, Guo X, Wang Z, Li S, Huang Y, Lei T.Antioxid Redox Signal. 2024 Oct 3. doi: 10.1089/ars.2024.0611. Online ahead of print.

 

Beyond Epistaxis: A Rare Case of Ectopic Sinonasal Adamantinomatous Craniopharyngioma.

Selva Kumaran K, Shamsudin NS, Dalip Singh HS, Devesahayam PR.Cureus. 2024 Sep 1;16(9):e68357. doi: 10.7759/cureus.68357. eCollection 2024 Sep.


Posterior pituitary tumors and other rare entities involving the pituitary gland.

Roncaroli F, Giannini C.Brain Pathol. 2024 Sep 30:e13307. doi: 10.1111/bpa.13307. Online ahead of print.PMID: 39350562 Review.

 

Pituitary Apoplexy in Pregnancy: Neonatal Implications.

Megan Y, Melissa S.Neoreviews. 2024 Oct 1;25(10):e660-e663. doi: 10.1542/neo.25-10-e660.

 

Giant pituitary macroadenoma with apoplexy presenting with isolated bilateral hypoglossal nerve palsy: illustrative case.

Zaher M, Kolmetzky DW, Al-Atrache Z, Vimawala S, Kolia NR, Godil SS.J Neurosurg Case Lessons. 2024 Sep 30;8(14):CASE24326. doi: 10.3171/CASE24326. Print 2024 Sep 30.

 

Typical Morphological Characteristics of the Immunohistochemistrical Subtypes of Pituitary Microadenomas: A dual center study.

Zhang L, Yan S, Xie SK, Wei YT, Liu HP, Li Y, Wu HB, Wang HL, Xu PF.Endocr Connect. 2024 Sep 1:EC-24-0378. doi: 10.1530/EC-24-0378. Online ahead of print.

 

 

Acromegaly

 

Efficacy and safety of pasireotide treatment in acromegaly: A systematic review and single arm meta-analysis.

Aliyeva T, Muniz J, Soares GM, Firdausa S, Mirza L.Pituitary. 2024 Oct 1. doi: 10.1007/s11102-024-01461-5. Online ahead of print.

 

Cushing’s

 

Frequency of clinical signs in patients with Cushing’s syndrome and mild autonomous cortisol secretion (MACS): Overlap is common.

Braun LT, Vogel F, Nowak E, Rubinstein G, Zopp S, Ritzel K, Beuschlein F, Reincke M.Eur J Endocrinol. 2024 Oct 1:lvae127. doi: 10.1093/ejendo/lvae127. Online ahead of print.

 

 

Pituitary Surgery

 

Stereotactic radiosurgery for recurrent/residual nonfunctioning pituitary adenoma: a single-arm systematic review and meta-analysis.

De Nigris Vasconcellos F, Vilela MAD, Torrico FG, Scalise MA, Vargas VPS, Mendieta CD, Pichardo-Rojas P, Rosi MEA, Fleury LT, de Brito Rebelo ND, Benjamin C, Sheehan JP.Acta Neurochir (Wien). 2024 Oct 2;166(1):392. doi: 10.1007/s00701-024-06296-4.PMID: 39356336 Review.

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

 

Hormonal Health


Prolactin deficiency in the context of other pituitary hormone abnormalities : Special issue: hypoprolactinemia: a neglected endocrine disorder.

Shimon I.Rev Endocr Metab Disord. 2024 Oct 2. doi: 10.1007/s11154-024-09902-z. Online ahead of print.PMID: 39356415 Review.

 

The Ser434Phe Androgen Receptor Gene Mutation Does Not Affect Fertility but is Associated with Increased Prolactin.

Saadeh NA, Obeidat M, Shboul M.Appl Clin Genet. 2024 Sep 26;17:143-149. doi: 10.2147/TACG.S466919. eCollection 2024.

 

PNA Spotlight: Dr. Yuval Eisenberg

This month the PNA Spotlight shines on Dr. Yuval Eisenberg.  Dr. Eisenberg graduated from Rush Medical College at Rush University Medical Center in 2009. He works in Chicago, IL and two other locations and specializes in internal medicine as well as endocrinology, diabetes & metabolism. Dr. Eisenberg is also affiliated with the University of Illinois Hospital Health & Science Center.  He was kind enough to answer some of our questions:

 

 What inspired you to choose your career path?

 

My career path was guided by my interaction with patients and by my mentors. The highlight of my medical school training was helping to diagnose a young man suffering from multiple endocrine neoplasia type 1 (MEN1), a rare genetic disorder causing multiple tumors, including a pituitary adenoma. Listening to his concerns and thinking outside the box, I helped provide him with the correct diagnosis and treatment plan – and started my journey into endocrinology. I have been fortunate to work with excellent clinician-educators in my career. Learning about and observing the care of patients with endocrine-related problems was fascinating and rewarding. The farther I got in my training, the more I realized that endocrinology was my passion and that patients with pituitary disorders would be my sub-focus. Patients with pituitary disease are a unique population who are in need of education, support and reassurance at diagnosis – and they often require long-term follow-up. This allows for time to develop a bond of trust; an aspect of medical practice I thoroughly enjoy.

 

What is the primary focus of your work/research?

 

My main focus is my clinical endocrinology practice, and I see a variety of patients, but I have a specialized interest in patients with pituitary disorders. My research interest is in the hormone oxytocin and how it might affect patients with pituitary hormone deficiencies (hypopituitarism).

 

What do you consider to be the future of your field?

 

In my opinion, the future is in specialized and individualized expert care when providing for patients with pituitary disorders. Given the rarity of these diseases, patients are best served by providers with interest and experience. Also, the more we know about pituitary tumors and the genetics behind them, the better we will be able to predict patient outcomes and tailor our therapies.

 

What should patients know about your field/what deserves more recognition/awareness?

 

My feeling is that patients need to know that they can/should advocate to get the care they deserve from providers with interest and experience in caring for individuals with their condition. They should also utilize the excellent patient-centered resources (like the PNA) to help educate and direct their care.

 

What would you like to convey about yourself to your patients?

 

The best part of my job is helping patients (and their families) understand their condition, their prognosis and their options. It’s tremendously rewarding to help someone feel more comfortable with what is often a completely foreign, and sometimes scary sounding group of diseases. I strive to always spend the time and energy needed to make patients feel more at ease with and educated about their disease.

  • Why did you get involved with the PNA and what is the extent of your involvement?

Early in my career, I became excited to become more involved. My mentor has also been involved in the PNA for many years and recommended I become involved, as he found it an excellent resource for patients and providers.

 

Available Now!

The Pituitary Patient Resource Guide Sixth Edition is now available! Be one of the first to have the most up-to-date information. The Pituitary Patient Resource Guide a one of a kind publication intended as an invaluable source of information not only for patients but also their families, physicians, and all health care providers. It contains information on symptoms, proper testing, how to get a diagnosis, and the treatment options that are available. It also includes Pituitary Network Association's patient resource listings for expert medical care.

Xeris Pharmaceuticals is valued member of the PNA

Continuing Education Program

If you are a nurse or medical professional, register for PNA CEU Membership and earn CEU credits to learn about the symptoms, diagnosis and treatment options for patients with pituitary disorders. Help PNA reduce the time it takes for patients to get an accurate diagnosis.

For more information click here!

Seventh Edition - Coming Soon!

The Pituitary Patient Resource Guide Sixth Edition is now available! Be one of the first to have the most up-to-date information.

The Pituitary Patient Resource Guide a one of a kind publication intended as an invaluable source of information not only for patients but also their families, physicians, and all health care providers.

It contains information on symptoms, proper testing, how to get a diagnosis, and the treatment options that are available. It also includes Pituitary Network Association’s patient resource listings for expert medical care.

PNA Gratefully Acknowleges Our Supporters