Lisa Nachtigall, MD, Clinical Director, Neuroendocrine and Pituitary Clinical Center at Massachusetts General Hospital, and Associate Professor at Harvard Medical School discusses acromegaly and pituitary tumors.

Acromegaly is a rare disorder caused by a noncancerous tumor on the pituitary gland, which is located just below the brain. The pituitary gland controls many body functions, including growth, metabolism and reproductive function.

In acromegaly, a tumor that grows on the pituitary gland produces too much GH, which can prompt the liver to overproduce IGF-1. Too much GH or IGF-1 in the bloodstream signals the body to grow, and can result in a wide range of signs and symptoms.

The growth hormone disorder acromegaly is usually caused by a pituitary tumor. These tumors are always benign (that is, non-cancerous). About 95% of cases of acromegaly are caused by a benign pituitary tumor. The other 5% of cases are caused by non-pituitary tumors; those tumors, usually located in other parts of the brain, the pancreas, or the lungs, can cause the body to secrete too much growth hormone

4b
Are pituitary tumors hereditary?
Sandra Ryan, Clinical Nurse Coordinator

Ron Ball traveled to Barrow Neurological Institute from Kansas to receive treatment for a tumor growing on his pituitary gland. In this video, he talks about what it is like to be diagnosed with a pituitary adenoma and his experience working with Dr. William White to formulate a treatment plan to return him to health. Ron is now living symptom and tumor free.

[Transcript]

[Narrator] In March 2020, college student Gianna Schembari began a battle with an illness that came out of nowhere.

- [Gianna} The most noticeable symptoms that happened that early were the significant weight gain, my mood swings, I just kind of started getting into like a really depressive state. I would get these headaches, would get heart palpitations. I mean, things just started getting worse very quickly.

- [Narrator] Months of tests ruled out many possible causes but yielded no clear diagnosis.

- [Gianna] There were so many times that I would just cry in my room because I didn't feel well. And there was nothing that anybody can do at that moment to make me feel better.

- [Narrator] Eventually, an MRI revealed a small benign tumor called a micro adenoma located on Gianna's pituitary gland, an indication of Cushing disease, a rare disorder that affects only 10 to 15 people per million.

- [Gianna] The endocrinologist had me take a medication that would supposedly shrink the tumor. It made me very, very sick. I could not function. I was in bed. We were just like, "okay maybe we need to go ask somebody else what they think."

- [Narrator] Gianna and her family turned to neurosurgeon, Dr. Michael McDermott, chief medical executive at Miami Neuroscience Institute.

- [Gianna] He said, "this is definitely Cushings." And we were like, "wait, we haven't had a diagnosis yet." He's like, "let me be the first to tell you that this is Cushings and this is the treatment."

- [Narrator] A multi-specialty team of physicians experienced in the treatment of pituitary tumors was assembled for Gianna's case, including Dr. Francisco Pernas, ear, nose and throat surgeon. And neurosurgeon Dr. Vitaly Siomin

- [Dr. Siomin] The pituitary gland is one of the most critical parts of the brain. And I would picture it as a command center that would produce the critical hormones and send them to, to the bloodstream. Cushing's disease is a condition when one of the hormones which is called ACTH is produced in excessive quantities.

- [Gianna] When I met with the team of all of my different doctors I just instantly felt like everything was gonna be okay. They knew exactly what it was. And then they just had their plan, as to the treatment.

- [Dr. Pernas] The team approach is really important. Some neurosurgeons will do the surgery on their own. The difficulty becomes in the nasal anatomy. We as ENTs are skilled at nasal anatomy we're skilled at nasal endoscopes. So we're working essentially, a four-handed person working together.

- [Dr. Siomin] The technology nowadays allows us to approach these tumors in a much less invasive way. We could put the scopes through the nostrils and navigate the scopes using what's called the image guidance technology. It is just like GPS that most people use for driving. We use the same technology for surgery that helps us to go directly to the tumor open up very minimally and resect the tumor using the endoscopic visualization.

- [Gianna] It's been about seven months since the surgery, And I feel amazing.

- [Dr. Siomin] This is before surgery and then this is the adenoma over here, with the measurements. And now this is after surgery. It's all gone. And you have normal pituitary gland tissue here.

- [Gianna] Before the surgery, I had high blood pressure, anxiety panic attacks, nausea, vomiting, all that stuff. And I was on about five medications. Since the surgery, I am not on one medication. And all of those symptoms are completely resolved.

- [Dr. Siomin] Gianna's doing very well. I think her prognosis is probably going to be excellent.

- [Gianna] They are the best doctors on earth. I feel like a whole new person. I basically got my life back and I'm super, duper happy.