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Acromegaly and Pituitary Tumor Centers of Excellence

Susan Samson, MD, PhD discusses acromegaly and the role of pituitary tumor centers of excellence. Acromegaly is a rare endocrine disorder usually caused by a benign pituitary tumor and is characterized by excess production of growth hormone and insulin-like growth factor-1 hormone. The best care for these patients is often provided by an interdisciplinary team composed of endocrinologists and experienced pituitary surgeons working in collaboration. This core team needs to be supported by a collaborative environment of specialists in other areas, such as neuroradiology, neuropathology, radiation oncology, neuro-ophthalmology, otorhinolaryngology, plus trained nursing. According to an article in Pituitary (Criteria for the definition of Pituitary Tumor Centers of Excellence [PTCOE]: A Pituitary Society Statement. 2017; 20(5): 489–498), the goals of Centers of Excellence should include a multidisciplinary team and should include: (1) early detection of the tumor; (2) establishing the diagnosis; (3) determination of the most suitable treatment, which can either be observation; surgical, medical or radiotherapy; (4) if surgical, removing the pituitary mass while preserving the normal pituitary tissue and nearby structures; (5) the surgical or medical treatments working alone or concomitantly must eliminate hormonal hypersecretion and/or its effects; (6) prevention of tumor recurrence; and (7) recognizing and caring for the acute and delayed complications of the disease, especially hypopituitarism. The final goal is the elimination or at least reduction of the excess morbidity and mortality associated with the tumor and hypersecretion syndrome as well as treatment of accompanying pituitary hormone insufficiencies. For many patients, this requires a program of care, including medical therapy, surgery and radiation therapy, in addition with long-term follow-up. To learn more about this and other endocrine disorders, visit checkrare.com/diseases/endocrine-disorders/