Minimally Invasive Neurosurgical Techniques Offer Extensive Benefits for Patients with Pituitary and Skull Base Tumors

Edward R. Laws, MD, Surgical Director of the Pituitary and Neuroendocrine Center at Brigham and Women’s Hospital is a world renowned pituitary neurosurgeon with more than 20 years’ experience providing specialized care for patients. Throughout his career, Dr. Laws has performed more than 5,000 transsphenoidal procedures for pituitary lesions and is employing new minimally invasive approaches in the treatment of patients withpituitary and skull base tumors.

Dr. Laws is part of an expert multidisciplinary team of specialists in the Pituitary and Neuroendocrine Center – dedicated to providing referring physicians with advanced options for patients with pituitary disease and skull base tumors. During one visit, patients are seen by both a neuroendocrinologist and a neurosurgeon. Along with other specialists, they collaborate to develop the best treatment approach for each patient.

State-of-the-Art Neurosurgical Care

Minimally invasive surgical options for patients with pituitary tumors include transnasal endoscopic surgery. The Center is one of few in New England to offer this technique, which uses the natural anatomy of the sinuses and image guidance for tumor resection and subsequent reconstruction.rnBenefits of transnasal endoscopic surgery include:
• Better visualization of the tumor;
• Greater preservation of the pituitary gland;
• No external incisions;
• Less pain and trauma for the patient;
• Significantly shorter hospital stay – two days, compared with five-to-seven days with open procedures.

In addition to transnasal endoscopic pituitary surgery, other advanced surgical techniques offered through the Center include transsphenoidal procedures for pituitary tumors and endoscopic approaches for craniopharyngiomas and other anterior skull base tumors. Based on pathology results, patients may be treated with adjuvant medical or radiation therapy.

Innovative Approaches in Neuroendocrinology

New medical therapies also are used to offer alternatives to surgery or radiation and help preserve pituitary function for patients with hormone-secreting pituitary tumors. Neuroendocrinologists in the Center are using:
• Dopamine agonists to control prolactin hormone excess and reduce tumor size in patients with prolactinoma;
• Somatostatin analogs to help normalize hormone levels and control progression of tumor growth – and as an adjunct to surgical treatment – for patients with acromegaly;
• The growth hormone receptor antagonist pegvisomant as a medical treatment for acromegaly.

About the Pituitary and Neuroendocrine Center rnComprised of an expert multidisciplinary team of neurosurgeons, neuroendocrinologists, radiation oncologists, neuro-ophthalmologists, otolaryngologists, and other specialists, the Pituitary and Neuroendocrine Center offers innovative and advanced treatment for a wide range of pituitary disease. These specialists also work as part of an integral team in the Center for Neuro-Oncology at Dana-Farber/Brigham and Women’s Cancer Center – joining medical oncologists and other specialists to care for patients with malignancies.