News Articles February 2022
Written on 04 February 2022.
News Articles April 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 April 2025
Sufficient sleep, exercise, healthy food, friendship, and peace of mind are necessities, not luxuries.” – Mark
PNA Spotlight: Dr. Jonathan Breshears
This month the PNA Spotlight focuses on Dr. Jonathan Breshears, a neurosurgeon at St. Luke’s Hospital in Kansas City, Missouri and a Clinical Assistant Professor in the Department of Surgery at the University of Missouri-Kansas City School of Medicine. Dr. Breshears did his undergraduate work and earned his M.D. at Washington University in St. Louis. He did a residency at UCSF Medical center and a fellowship in open and endoscopic skull base surgery at MD Anderson Cancer Center. He specializes in the treatment of benign and malignant tumors involving the brain and skull base, particularly pituitary tumors, acoustic neuromas, and meningiomas. He was kind enough to answer a series of questions from the PNA. Here are his answers, lightly edited for clarity.
Please tell us a little bit about your practice
I did my neurosurgery training at UCSF, and there I had the good fortune to be exposed to some really excellent pituitary surgeons including Sandeep Kunwar, Manish Aghi, and also Louis Blevins. They are my early mentors in pituitary surgery, and how I got exposure to the PNA. From there, I did a skull base fellowship at MD Anderson and had more specialized training in taking care of lesions on the base of the skull, and pituitary tumors as a part of that. My practice now is in Kansas City, Missouri, at the St Luke’s Hospital at the Marion Bloch Neuroscience Institute. I’ve been here five years, and we’ve built up a multi-disciplinary team, including endocrinologists, neuropathologists, neuroradiologists, a neuro ophthalmologist as well as my anterior skull base partner, Dr. Vidur Bhalla, who’s a rhinologist trained in skull based surgery. We have a multi-disciplinary program to help take care of patients with pituitary tumors, because those tumors require a team of highly trained specialists. We have all those people in place, part of a specialized program to help take care of these patients. We also have a nurse navigator for our program, so when we get referrals or when people call in, especially if there’s an acute symptom like vision loss, we really try to expedite their care. This way they are able to see multiple specialists and get the labs and the imaging they need as a part of the workup, all in the same day. This minimizes the number of trips the patient has to make.
Read More Here
How a Mayo Clinic-Led Imaging Breakthrough Is Transforming Pituitary Tumor Diagnosis and Treatment
For patients dealing with pituitary tumors, an accurate diagnosis is the first step toward effective treatment. But in many cases—especially with rare conditions like Cushing’s disease—the tumors can be so small that standard imaging protocols struggle to detect them. Now, thanks to a cutting-edge technology called Photon Counting Detector CT, doctors are seeing these elusive tumors with greater clarity than ever before.
Pioneered in collaboration with Mayo Clinic physicians and researchers, Photon Counting Detector CT showed promising results in a recent Mayo-led study.
Pituitary tumors, particularly those responsible for Cushing’s disease, can be extremely small—sometimes only a few millimeters in size. While traditional MRI is the standard imaging protocol for these tumors, it sometimes doesn’t provide enough detail to precisely locate them. In fact, MRI has historically failed to detect pituitary tumors in nearly 50% of Cushing’s cases. This can leave patients facing additional testing or even exploratory surgery, which can be risky and invasive given the pituitary gland’s small size and delicate nature. Current MRI technology may not get high enough spatial resolution to capture these small tumors of 2mm to 3 mm, and higher field strength MRI scanners have challenges with imaging distortions at the skull base where these tumors are found.
“Cushing’s tumors are among the hardest to find because they’re so tiny and blend in with normal pituitary tissue,” explains Mayo radiologist Dr. Ian Mark. “With Photon-Counting Detector CT, we’re seeing details we simply couldn’t see before. It allows us to locate tumors that are hard to detect on MRI. This means patients can have a more targeted surgery with a better chance of success.”
Mayo neurosurgeon Dr. Jamie Van Gompel adds, “If I know where the tumor is and I can confidently go get it, I’m going to have an 80% rate of cure as opposed to 50% with exploration.”
For patients, the benefits of Photon Counting Detector CT are compelling. Earlier and more accurate diagnosis reduces the need for additional testing. The enhanced imaging it enables gives neurosurgeons a better-informed preoperative plan, which can reduce the need for exploratory procedures and lead to better outcomes.
“It’s a true game changer for patients with Cushing’s disease and other complex pituitary conditions,” says Dr. Van Gompel. “By improving our ability to see these tumors before surgery, we’re improving the likelihood of curing the disease with the least amount of intervention,” adds Dr. Mark.
For Drs. Mark and Van Gompel, the technology is emblematic of Mayo Clinic’s multidisciplinary approach to patient care. “Things like this only occur at places where you have lots of people from different disciplines sitting down, talking about problems, and looking for new ways that we can help our patients. I think that’s one of the things we do best here,” says Dr. Van Gompel.
The rarity of Cushing’s disease makes it challenging to study, but future research with larger patient groups is planned. While it’s still a relatively new technology in pituitary tumor diagnosis, its long-term potential as a complement to MRI is clear. As it becomes more widely adopted, it could become a key tool in advancing the treatment of complex pituitary diseases, helping more patients get the care they need—faster and with greater precision.
Developed in collaboration with Mayo Clinic’s team of multidisciplinary experts, Photon Counting Detector CT is readily available at Mayo Clinic. If you’re facing a pituitary tumor diagnosis, contact a Mayo Clinic specialist to learn more about your imaging and treatment options.
For more information or to request an appointment, please visit Pituitary Tumor Care – Mayo Clinic
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.
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April 2025 Research Articles
Pituitary Surgery
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.
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.
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
Pekic Djurdjevic S, Arsic Arsenijevic V.J Fungi (Basel). 2025 Mar 19;11(3):233. doi: 10.3390/jof11030233.
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
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
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.
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
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.
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.
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. Dr. Jonathan Breshears
PNA Spotlight: Dr. Jonathan Breshears 
This month the PNA Spotlight focuses on Dr. Jonathan Breshears, a neurosurgeon at St. Luke’s Hospital in Kansas City, Missouri and a Clinical Assistant Professor in the Department of Surgery at the University of Missouri-Kansas City School of Medicine. Dr. Breshears did his undergraduate work and earned his M.D. at Washington University in St. Louis. He did a residency at UCSF Medical center and a fellowship in open and endoscopic skull base surgery at MD Anderson Cancer Center. He specializes in the treatment of benign and malignant tumors involving the brain and skull base, particularly pituitary tumors, acoustic neuromas, and meningiomas. He was kind enough to answer a series of questions from the PNA. Here are his answers, lightly edited for clarity.
Please tell us a little bit about your practice
I did my neurosurgery training at UCSF, and there I had the good fortune to be exposed to some really excellent pituitary surgeons including Sandeep Kunwar, Manish Aghi, and also Louis Blevins. They are my early mentors in pituitary surgery, and how I got exposure to the PNA. From there, I did a skull base fellowship at MD Anderson and had more specialized training in taking care of lesions on the base of the skull, and pituitary tumors as a part of that. My practice now is in Kansas City, Missouri, at the St Luke’s Hospital at the Marion Bloch Neuroscience Institute. I’ve been here five years, and we’ve built up a multi-disciplinary team, including endocrinologists, neuropathologists, neuroradiologists, a neuro ophthalmologist as well as my anterior skull base partner, Dr. Vidur Bhalla, who’s a rhinologist trained in skull based surgery. We have a multi-disciplinary program to help take care of patients with pituitary tumors, because those tumors require a team of highly trained specialists. We have all those people in place, part of a specialized program to help take care of these patients. We also have a nurse navigator for our program, so when we get referrals or when people call in, especially if there’s an acute symptom like vision loss, we really try to expedite their care. This way they are able to see multiple specialists and get the labs and the imaging they need as a part of the workup, all in the same day. This minimizes the number of trips the patient has to make.
What would you say inspired you to go into this field?
When I started medical school, my background was in engineering. One of the neurosurgeons at Washington University was doing research on brain computer interfaces and the application of engineering technology to try to better understand the brain. So I spent time doing research in his lab, which exposed me to the culture of neurosurgery. And that’s really where my interest in neurosurgery started. As I went through my training at UCSF and got more actual clinical exposure and training, I developed an interest in pituitary and skull-based surgery.
How would you say your field has evolved?
I think the standards have gone up as the training has gotten better. Certainly, technology has changed. I do surgery endoscopically, but I was trained by people who do it microscopically. The technology in either case is better now, the image guidance has improved. All of it is better. However, in addition, the bar has been raised for what the outcomes of surgery should be. These days, there’s a more mainstream understanding that this surgery is really best done by specialists who work as a part of a multi-disciplinary team, which results in better outcomes for patients. The standards of surgical technique are higher and include pseudo capsular dissection and minimizing residual tumor left behind, doing things like medial cavernous sinus wall resection to ensure that you cure disease for secreting tumors. With more focus on the disease and more study into surgical techniques, the standards have gone up over time. It used to be the case 20 or 30 years ago that to really have an expert pituitary surgeon, you had to really travel far. But now, the training has been disseminated, so now the surgical standard is more uniform across the country.
I imagine the key, first, is to be sure patients get diagnosed correctly and early on.
Yes. There are still those really sad cases where people have been losing vision for years, and no one realized what was going on, and then they finally figure it out, very late in the game. But we are raising the bar for pituitary care in the region. I’m in a more rural area of the country, and someone from a small town just a couple hours away can come here and get expert care. We can take care of their tumor, as opposed to them having to travel across the country to a major center. We are now providing that level of care in the region.
What made you want to be a part of the PNA?
I like how the organization provides a place for patients to go to find people who specialize in in this type of surgery. Again, it’s something where you really want to be treated by people who are dedicated to doing this, and do a lot of it. I first heard about the PNA from my mentors at UCSF.
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.
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.
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.
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.
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.
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October 2024 Research Articles
Pituitary Tumors
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.
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.
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.
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
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
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
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
Shimon I.Rev Endocr Metab Disord. 2024 Oct 2. doi: 10.1007/s11154-024-09902-z. Online ahead of print.PMID: 39356415 Review.
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.
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Continuing Education Program
