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Pituitary Gland Tumor / Pituitary Adenoma
Radiosurgery

Email Dr. Jeffery Williams (jw@jhu.edu). For pituitary gland tumors including pituitary adenoma, prolactinoma and Cushings disease, the decisions related to treatment for the pituitary gland tumors depend upon the complete understanding of the competing risks vs. benefits for the different treatments. Options for pituitary gland tumor treatments may include surgery or radiosurgery. The FSR (fractionated stereotactic radiosurgery) for pituitary tumors is an important option for treatment. The important considerations include the size and rate of growth of the pituitary tumor as well as the progression of any symptoms.

Click Here for Dr. Williams C.V. Curriculum Vitae: Dr. Jeffery Williams
Director, Brain Tumor Radiosurgery
The Johns Hopkins Hospital
Board Certified: Neurological Surgery
Board Certified: Radiation Oncology
Email Dr. Jeffery Williams.

Email Address: jw@jhu.edu
Phone: 410-614-2886
Fax: 410-614-2982

Pituitary Adenoma On-Line Consultation

  • Pituitary tumors can be treated with surgery, radiotherapy, radiosurgery and/or medications.

  • For On-Line Consultation for pituitary gland tumors please complete and send the Patient and Tumor Info and email Dr. Williams jw@jhu.edu.

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Pituitary Adenoma Topics

Pituitary Adenomas
Pituitary adenomas cause specific clinical syndromes.



Johns Hopkins Pituitary Radiosurgery

Pituitary adenomas have specific signs and symptoms that are primarily related to the endocrinopathies produced by hypersecretion.

  • The prolactin-secreting pituitary adenomas are the most common, and account for approximately 30% of all pituitary tumors. The clinical findings are galactorrhea and reproductive dysfunction.

  • The endocrinopathy of excess growth hormone results in enlargement of the extremities, face and the soft tissues, producing a characteristic appearance called acromegaly. Acromegaly can be associated with hypertension, diabetes mellitus and cardiovascular disease. Further, acromegaly is associated with decreased life expectancy.

  • Cushing's syndrome results from hypercortisolism and is characterized by distinctive clinical features. Patients may develop obesity, hirsutism (abnormal hair distribution), purple striae (stripes) on the skin, mental problems, poor wound healing and muscle wasting.

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Microsurgical resection of pituitary adenomas can be done via two approaches.

Microsurgical resection of pituitary adenomas can be done via two approaches.

  • The transphenoidal approach allows resection of small to medium-sized tumors. The risks of surgery include CSF (spinal fluid leak) and meningitis. The rates of these complications are low, however.

  • The pterional approach allows greater visualization and exposure of larger pituitary adenomas.

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Stereotactic Radiosurgery offers non-invasive control of newly diagnosed or recurrent pituitary tumors.

Stereotactic Radiosurgery allows specific irradiation of only the pituitary tumor. Narrow beams of radiation specifically target only the pituitary tumor. The normal brain is spared and does not receive significant exposure. For treatment there are no "pins" placed in the scalp as with single fraction techniques. The treatment results in control of the majority of tumors and their endocrinological sequelae. Stereotactic radiosurgery may be particularly suitable for functional pituitary adenomas (Cushing's disease, Acromegaly) to reduce the level of hormonal secretion. For recurrent pituitary adenomas after conventional surgery and radiation, stereotactic radiosurgery is particularly appropriate, allowing sparing of the optic nerves with delivery of high radiation dose to the recurrent pituitary adenoma.

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The patient information may be submitted.

Stereotactic Radiosurgery offers specific, local treatment to the pituitary adenoma with sparing of surrounding normal tissues. The stereotactic radiosurgery is most often used for recurrent pituitary adenomas that have returned after prior surgery. The options for radiosurgery include the single session technique versus the fractionated stereotactic radiosurgery (FSR). How close the optic nerve(s) are to the pituitary tumor determines if single session or fractionated stereotactic radiosurgery is safer. The form below may be used to relay the important information regarding the pituitary tumor if helpful to the patient.



Pituitary Adenoma Patient and Tumor Information

The form below can allow discussions for patients who have pituitary adenoma. It outlines many of the important questions related to pituitary adenoma and its treatment. The treatment options for pituitary adenomas are multi-factorial and depend upon many different characteristics of the patient and the tumor. These include the size of the pituitary tumor, the interval since prior treatment (if given) the endocrine production by the tumor, the symptoms and the rate of change of the symptoms. For rapidly progressive pituitary tumors, surgery may be the first consideration. For slowly growing pituitary gland tumors, the radiosurgery offers treatment. The form can be sent to Dr. Williams using the "Send Form" button at the end of the page. Dr. Williams can subsequently correspond regarding the issues related to the treatment options for pituitary adenomas. This information helps determine which of the different therapies may be helpful for treatment. Even though all of the information below may not be available, please submit all that is known.

There are two ways to relay the information:

  • Email Dr. Williams regarding Pituitary Adenoma treatment options: Dr. Jeffery Williams

  • Send the form and include your email address in the box at right (if response is desired):

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Please enter the responses and click on the "Submit Form" button at the end of this form.

Date of Diagnosis

What is the DATE of the diagnosis of the pituitary adenoma?




  • Method of Diagnosis

    How was the first pituitary adenoma diagnosed?

    Craniotomy

    Endocrine studies (blood tests)

    Only radiographically




  • Location

    What was the location of the pituitary adenoma?

    Sella Turcica (Normal Location)

    Extension beyond sella (suprasellar or into cavernous sinus(es))



  • Size: What is the size of the pituitary adenoma (largest dimension)?

    Less than one centimeter

    Greater than one, but less than two centimeters

    Greater than two, but less than three centimeters

    Greater than three centimeters




  • Endocrine Studies

    Does the patient have above-normal secretion of any hormone(s) (Prolactin, ACTH, Growth Hormone, Other) by the pituitary pituitary adenoma as documented by laboratory studies?

    No

    Yes


    (Please list hormone(s)):

    ACTH

    Prolactin

    Growth Hormone

    Other:




  • Syndromes

    Does the patient have either of the following syndromes?
    Cushings Disease

    Acromegaly

    Hyperprolactinemia




  • First (Prior) Treatment (if applicable): How was the first pituitary adenoma treated?

    Observation Only

    Medication

    Subtotal Resection

    Total Resection

    Surgery (subtotal or total) and radiation




  • Date First Treatment

    What was the DATE of the treatment for the FIRST pituitary adenoma?






Current Pituitary Adenoma
  • What is the DATE of the DIAGNOSIS of the CURRENT pituitary adenoma (if current is different from above)? This pituitary adenoma is for consideration for the CURRENT radiosurgery or surgical resection.




  • Growth of Tumor

    Has the pituitary adenoma GROWN in size since a prior treatment or initial diagnosis? No

    Yes




  • Surgical Management of Current Tumor

    Prior to Radiosurgery, if given, how is the CURRENT pituitary adenoma (or group of pituitary adenomas) surgically treated?

    Subtotal Resection

    Total Resection

    No Surgery




  • Histology

    Please enter the histology:

    Benign

    Malignant

    Atypical

    Other (not listed above):



Thank you for completing the Johns Hopkins Pituitary Adenoma Questionnaire.


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