The physicians at the UW Medicine Pituitary Program provide comprehensive treatment to patients with disorders of the pituitary gland and hypothalamus.
Here’s a list of the services available at the clinic:
Our endocrinologists are experienced in the administration of replacement hormones. They may also recommend medications to block syndromes that result in excess hormones (such as prolactinomas, growth-hormone secreting tumors, Cushing’s disease and thyroid-secreting tumors).
- Our endocrinologists are also experienced in the use of investigational drugs for the treatment of prolactin and growth hormone disorders.
- They have been at the forefront of medical therapy for pituitary disorders, such as treating prolactinomas with dopamine agonists.
- Our neuroendocrine clinical nurses offer patient education, including self-administration of medications requiring injection.
Our surgical neuropathology consultation service provides expert, timely diagnosis of pituitary disorders.
- Our specialists analyze frozen tissue for rapid diagnosis, which allows surgeons to adjust treatment in the operating room.
Neuropathologists also provide support to ongoing clinical trials for pituitary disorders in addition to collaborating with other specialized centers of excellence.
The program offers state-of-the-art neuroradiology services to detect pituitary tumors. The specialists on our neuroradiology team are experts in diagnosing and evaluating patients before and after medical or surgical treatment.
Here are some of the studies your doctor may recommend:
- Typically, diagnosis will begin with a magnetic resonance imaging (MRI) study. Our cutting-edge scanners (3T and 1.5T), all equipped with the most up-to-date software, produce high-resolution images that allow doctors to better find and treat your tumor.
- We can also do dynamic pituitary imaging where a contrast agent helps radiologists identify normal tissue and pituitary lesions. This technique is especially useful in identifying small tumors that may be difficult to discern in standard images.
- High-resolution, 3-D MRI technology allows doctors to see even the smallest biologically active tumors, which are invisible in standard images.
- A diagnosis of Cushing’s disease can be further clarified through a procedure called cavernous sinus and inferior petrosal sinus sampling (IPSS).
If you have any of the common symptoms of an expanding pituitary tumor (changes in vision, double vision), our neuro-ophthamology team can perform a detailed evaluation, which can help minimize the damage caused by the expanding tumor and preserve and/or restore your vision.
We have a highly skilled neurosurgical team who specialize in a minimally invasive procedure called endoscopic transnasal transsphenoidal surgery. In some instances, however, a more invasive procedure called a craniotomy is necessary to safely and completely remove the tumor.
Our surgeons are well versed in the newest endscopic techniques, as well as intraoperative CT scan and image guidance and gamma knife radiosurgery.
Here’s a breakdown of the different surgical procedures your surgeon may recommend:
Endoscopic Transnasal Transsphenoidal Surgery (TSS)
Endoscopic TSS is a minimally invasive procedure in which your surgeon uses a flexible endoscope to remove the pituitary tumor.
The benefits include the following:
- No incisions in your scalp, inside your nose or under your lip
- Minimal blood loss
- Low complication rate
- No nasal packing
- Tumors as large as 5 cm can be removed this way
- In most cases, the tumor can be removed without affecting the gland itself
- A majority of patients are discharged the day after surgery
Extended Enodoscopic Transnasal Transsphenoidal Surgery (TSS)
Extended TSS is used to treat tumors in the brain that cannot be reached by the standard method. The benefit here is that a craniotomy (temporary surgical removal of a part of the skull) is not needed.
While most pituitary tumors can be treated endonasally, if your tumor is large and not accessible through the nose, your doctor may recommend a minimally invasive procedure called a keyhole craniotomy. This involves temporarily removing a small section of skull to reach the tumor.
Gamma Knife Radiosurgery
Your doctor may recommend gamma knife radiosurgery if your tumor cannot be removed surgically or if it comes back after surgery.
The gamma knife does not actually involve cutting a tumor with a knife or scalpel. Instead the procedure, also known as stereotactic radiosurgery, uses high-energy gamma rays to pinpoint and destroy tumors. This targeted therapy also minimizes the effects of radiation on your pituitary gland and optic nerves, thus reducing side effects.