Why It’s Safer Than Ever To Remove Pituitary Tumors

Removing a pituitary tumor by surgery can be tricky. The gland is surrounded by carotid arteries, optic nerves, and lots of important brain matter. Nor is it easy to access or visualize. But with the help of revolutionary technology and modern expertise, surgeons are now able to remove pituitary tumors in a safe and minimally invasive way. / Image courtesy of Mayfield Brain & Spine

There are three basic things you should know about your pituitary gland: it’s buried away at the base of your brain; it’s very important; and, alas, it has a habit of growing tumors.

Did your pulse quicken a tiny bit at mention of “tumors?” If so, it’s because your thyroid told it to, on instructions from your pituitary gland. But now it’s normal again, right? For that you can thank cortisol, which your pituitary gland told your adrenal glands to make in response to stress.

That’s just the tip of the iceberg, according to Yair Gozal, MD, neurosurgeon at Mayfield Brain & Spine.

“The pituitary gland is also known as the master gland,” he explains. “It regulates the release of hormones from other glands, controlling blood pressure, urine output, body temperature, growth, metabolism, lactation, ovulation, testosterone, stress response, and more.”

That of course means when something is wrong with your pituitary gland—say, a tumor—the symptoms can vary. Perhaps the tumor grows from the part of the pituitary gland that produces prolactin, which regulates sexual function. In that case, a prolactinoma will result in halted menstruation or erectile disfunction (among other things.) Alternatively, suppose the tumor grows from the part of the pituitary gland that produces growth hormone. These tumors cause gigantism in children and acromegaly in adults (again, among other things.)

So it follows, the part of the pituitary gland where the tumor grows will determine its symptoms. But these only account for “functioning” tumors—that is, tumors that secrete too much or too little of a particular hormone. Other tumors, termed “non-functioning,” do not secrete hormones at all. These buggers just take up space until they begin pressing on adjacent parts of the brain that would rather not be pressed on. Symptoms include headache, vision loss, nausea, vomiting, or fatigue. Non-functioning tumors can also pinch the pituitary gland itself, resulting in a broad-based loss of pituitary function.

Pituitary tumors are unusually common. Fifteen percent of adults have one. Most do not cause symptoms or require treatment. If you have one that does, your treatment may involve medication, radiation, and surgery.

Removing a pituitary tumor by surgery can be tricky. The gland is surrounded by carotid arteries, optic nerves, and lots of important brain matter. Nor is it easy to access or visualize. But with the help of revolutionary technology and modern expertise, surgeons are now able to remove pituitary tumors in a safe and minimally invasive way.

For the vast majority of cases, surgeons opt for a transsphenoidal approach. Here, the surgeon inserts an endoscope through the nostril to reach the pituitary gland. The endoscope’s camera relays video to a monitor, which allows the surgeon to visualize the tumor and be precise while removing it. Nowadays the surgeon is further aided by computer image guidance. The computer system gives the surgeon a real-time, three-dimensional model of his or her instruments in the operating space, adding extra degrees of precision—and safety—to the procedure.

“Technology has really moved ahead in this field,” says Gozal. “You get such good visualization. It’s made the operation relatively straightforward.”

Straightforward, that is, for a multidisciplinary team of neurosurgeons, ENT surgeons, and endocrinologists equipped with all that technology and all their training.

“I wouldn’t go anywhere that didn’t have a team for this,” says Gozal. “It’s all about developing expertise. That’s the key. It’s the expertise that has made this safer to do.”

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Internationally recognized as a leader in neurological surgery, Mayfield has forged a rich and lasting heritage through technical innovation, research, and a commitment to patient care. Mayfield physicians are continuously recognized among the Best Doctors in America and Top Doctors in Greater Cincinnati.

Mayfield Brain & Spine has four convenient locations in Greater Cincinnati: Rookwood Exchange (3825 Edwards Road, Suite 300, Cincinnati, 45209); Green Township (6130 Harrison Ave., 45247); West Chester (9075 Centre Point Drive, 45069); and Northern Kentucky (350 Thomas More Parkway, Suite 160, Crestview Hills, 41017).

 

From https://local12.com/sponsored/why-its-safer-than-ever-to-remove-pituitary-tumors

One Response

  1. Thank you for posting this. I had Cushings disease and was fortunate to have my transphenoidal surgery with Dr Edward Laws as my surgeon and Dr Laurence Katznelson as my endocrinologist At Stanford University Med center. It’s a horrible disfiguring disease. I’m so grateful it’s getting more press coverage and that more doctors are becoming aware of it. I suffered over10 years with no diagnosis.

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