The Washington University and Barnes-Jewish Pituitary Center is the St. Louis region’s first multidisciplinary center dedicated to treating patients with pituitary tumors. It offers equipment and techniques that include intraoperative MRI. Surgical approaches include transnasal endoscopic surgery and use of the Gamma Knife to target tumors with a concentrated beam of radiation.
Julie Silverstein, MD, a Washington University endocrinologist at Barnes-Jewish Hospital, says management of pituitary tumors and related hormonal problems is best done by a collaborative team of specialists. This approach addresses surgical and nonsurgical issues and ensures patients receive coordinated care.
“Typically, our patients are seen by an endocrinologist and neurosurgeon the same day and get streamlined referrals to related specialties, including ENT, radiation oncology or interventional neuroradiology,” says Silverstein.
“Another of the center’s strengths is our experience treating prolactinproducing adenomas, which account for 30 percent of pituitary tumors. Most can be treated medically, but others may require a combination of medication, surgery and radiotherapy.”
The Pituitary Center also has expertise treating somatroph and corticotroph adenomas. Somatroph adenomas secrete growth hormone, resulting in acromegaly that causes enlargement of the jaw, hands and feet. Corticotroph adenomas produce ACTH and cause Cushing’s syndrome, characterized by weight gain, bruising skin and elevated blood pressure and blood sugar.
The center’s multidisciplinary team provides long-term follow-up care for patients with pituitary tumors.Some patients require little or no treatment beyond periodic MRIs to monitor tumor growth. Others are followed after treatment to monitor for the development of hormonal deficiencies and regrowth. The center works closely with primary care physicians and endocrinologists who treat patients living outside the metropolitan St. Louis area and provides patient access to clinical trials.