Our team of specialists treats a variety of diseases and disorders that arise in the pituitary gland and central nervous system. These tumors can cause symptoms including headaches, hormonal imbalances, and visual disturbances.
We offer a range of services, including radiologic evaluations and neurosurgical solutions.
Conditions we treat
We treat the following types of conditions:
- Pituitary tumors: Hormonally active tumors, such as prolactinomas, and silent or non-functioning
- Pituitary dysfunction: Conditions that include growth hormone deficiencies, hypothyroidism, Addison's disease, and diabetes insipidus
- Other conditions and tumors: Craniopharyngiomas, menigiomas, optic gliomas, and Rathke's cleft cysts/pituitary cysts
Pituitary tumors include hormonally active tumors, non-functioning (silent) tumors, and thyrotoph secreting tumors:
- Hormonally active tumors produce large amounts of normal hormones. They include:
- Acromegaly, which is caused by a pituitary tumor that secretes growth hormone. Acromegaly may cause gigantism in childhood or symptoms from headache to facial and foot enlargement in adults.
- Cushing's disease, which is caused when the adrenal glands produce too much cortisol as a result of a microadenoma (a small pituitary tumor) and excessive adrenocorticotropic hormone (ACTH)
- Prolactinoma, which is the most common hormone-producing tumor. Prolactinoma produces excess amounts of a hormone called prolactin.
- Non-functioning tumors (silent tumors) are the most common type of pituitary adenoma (benign tumor that forms in gland tissue). They produce little or no amounts of hormones. Typically, these tumors grow until their size begins to compress surrounding structures and cause symptoms. Symptoms include bitemporal hemianopsia (loss of vision to the sides), hypopituitarism (not enough pituitary hormones), and headache.
- Thyrotroph secreting tumors are rare tumors that secrete the hormone thyrotropin TSH (thyroid stimulating hormone). They include recurrent tumors, which are tumors of the pituitary that return after treatment, and pituitary carcinomas, which are rare, malignant pituitary tumors. Pituitary carcinoma account for 0.1 to 0.2% of all thyrotroph secreting tumors.
We treat pituitary dysfunction, including conditions such as:
- Diabetes insipidus, which is caused by the inability of the kidneys to conserve water. This leads to frequent urination and pronounced thirst.
- Growth hormone deficiency, which is caused when the pituitary gland does not create enough human growth hormome. Too little growth hormone during childhood can cause a child to grow less than normal.
- Male hypogonadism, which is caused by a man's testes failing to produce normal levels of the male sex hormone, testosterone. Some men are born with hypogonadism, while others may develop the condition later in life.
- Hypothyroidism (excess thyroid hormones), which occurs when the thyroid gland produces fewer hormones than the body needs
- Hypoadrenalism (Addison's disease), which occurs when the adrenal glands do not produce enough of the hormones your body needs to work properly. This affects the balance of water, sodium, and potassium in the body, and harms the body's ability to control blood pressure and react to stress.
In addition to strictly pituitary tumors, we also treat the following conditions:
- Craniopharyngiomas, which are benign tumors that develop near the pituitary gland
- Meningiomas, which can occur near the pituitary gland and are often benign
- Optic gliomas, which are tumors that originate and grow within the brain and press on the optic nerve and nearby structures. To learn more about these types of tumors, refer to the optic glioma topic on the MedlinePlus website.
- Rathke's cleft cysts/pituitary cysts, which are rare benign cysts that may cause symptoms such as headache and visual impairment when they are large
We offer outpatient evaluation in a joint neuroendocrine clinic, where you can be evaluated by both neurosurgeons and endocrinologists.
Our complete neuroradiological evaluations include:
- Angiography: Radiographical studies of blood vessels, especially useful in the diagnosis and surgical planning for Cushing's disease
- CT (Computed Tomography): An imaging method that uses X-rays to create cross-sectional pictures of the body
- MRI (magnetic resonance imaging): A non-invasive way to take pictures of the body using powerful magnets and radio waves
- MRA (magnetic resonance angiography): An MRI exam of the blood vessels
Neurosurgical procedures for pituitary tumors generally involve one of two forms:
- Transsphenoidal microneurosurgery is by far the most common surgical procedure for treating pituitary tumors. It is a minimally invasive surgical procedure performed through the nose to remove tumors from the pituitary gland. With this surgery, the tumor can then be removed while the normal pituitary gland is protected.
- Transcranial microneurosurgery is generally reserved for very large tumors.
Your endocrinologist and neurosurgeon will discuss the benefits and risks of undergoing these procedure after your diagnosis.
Our state-of-the-art operating rooms are equipped with:
- Operative microscope
- Computer-guided navigational system
- Neuroendoscope (a small camera attached to a rigid or flexible scope)
The neurosurgical and radiation oncology team performs LINAC (linear accelerator) based radiosurgery, a precisely targeted radiation beam via a metal frame attached to your skull.
Radiological suites are available for inferior petrosal sinus sampling, a test that measures adrenocorticotropic hormone (ACTH) levels in the veins that drain the pituitary gland.
We hold regularly scheduled neuroendocrine conferences to discuss treatment options for you in the presence of neurosurgeons, endocrinologists, neuro-oncologists, radiologists, and radiation oncologists.