The acorn-sized pituitary gland, located beneath the brain, is prone to developing slow-growing, benign tumors. Although many of them don’t produce symptoms, some may increase or decrease production of pituitary hormones. And, depending on location, they also may cause symptoms like headaches and vision loss.
“Many patients with pituitary tumors don’t require treatment but simply need regular follow-up. Others need neurosurgery, while some need both surgery and radiation treatments. There also are certain types of pituitary tumors that respond well to medication,” says Julie Silverstein, MD, a Washington University endocrinologist at Barnes- Jewish Hospital. “Determining the most effective course of treatment takes a cooperative effort among multiple specialists.”
The Washington University and Barnes-Jewish Comprehensive Pituitary Center is the region’s only clinic to offer a convenient, multidisciplinary approach to treating patients with pituitary tumors. The center provides patients with access to specialists as well as the latest and best technology for treating pituitary tumors. Most patients needing surgery undergo a minimally invasive procedure during which an ear, nose and throat (ENT) surgeon inserts an endoscope into the patient’s nose. Once at the tumor site, a neurosurgeon removes the growth.
“We use an innovative surgical navigation system—much like GPS— to guide us to the tumor,” says Michael Chicoine, MD, a Washington University neurosurgeon at Barnes-Jewish Hospital.
This system, called intraoperative MRI (iMRI), allows neurosurgeons and radiologists to immediately determine whether the entire pituitary tumor has been removed.
“If a fragment remains, we can perform immediate follow-up surgery. This is especially important when treating hormone-secreting tumors, since any small piece left behind will continue producing that hormone,” says Chicoine.
In cases where the tumor has invaded areas containing vital nerves or arteries, Gamma Knife radiosurgery may be used to target the tumor with a beam of radiation.