Erica Giraldi

2178 Sustained Post-Operative Nadir Cortisol Outperforms 8-Week Nadir as a Prognostic Biomarker of Recurrence in Pathology-Confirmed Cushing Disease

Richard J. Chung, Oumou Kalsoum Mbacke, Tanvika Vegiraju, Gregory K. Hong et autres

INTRODUCTION: Predicting recurrence and long-term remission after transsphenoidal surgery for Cushing's disease remains clinically challenging. METHODS: We performed a retrospective analysis of patients with pathology-confirmed Cushing disease who underwent transsphenoidal surgery between 2007-2019 and achieved post-operative biochemical remission. Sustained nadir was defined …

1195 Comparison of Pseudocapsule Dissection Techniques on Remission and Recurrence in Cushing’s Disease: A Retrospective Cohort Study

Jared H. Chung, Georgios Maragkos, Georgios Mantziaris, Michael Paul Catalino et autres

INTRODUCTION: Transsphenoidal resection (TSR) remains the primary treatment for Cushing’s disease. Prior studies have suggested that exploiting the tumor pseudocapsule—a fibrous boundary between adenoma and normal pituitary—may enhance surgical precision and reduce recurrence. METHODS: We retrospectively reviewed 102 Cushing’s disease patients who …

The cross-talk between prolactin and growth hormone in pituitary adenomas

Erica Giraldi, Matthew McCord, Adriana G. Ioachimescu

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Postoperative Body Mass Index Change Following Curative Transsphenoidal Surgery in Cushing's Disease

Jared H. Chung, Kathryn Chung, Georgios Α. Maragkos, Gregory K. Hong et autres

Introduction: Cushing’s disease causes substantial weight gain due to chronic hypercortisolism, yet postoperative weight trajectories after remission remain variable. Transsphenoidal surgery (TSS) is the standard curative approach, but the expected trajectory and likelihood of BMI improvement after successful surgery are uncertain. Prior …

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Clinical Impact of Pseudocapsule Dissection on Early Cortisol Suppression and Length of Stay in Cushing's Disease

Jared H. Chung, Georgios Α. Maragkos, Georgios Mantziaris, Gregory K. Hong et autres

Introduction: Early postoperative cortisol decline is a critical marker of biochemical remission in Cushing’s disease and achievement of nadir cortisol <2 µg/dL is a well-established predictor of long-term outcomes. The pseudocapsule surrounding ACTH-secreting adenomas provides a natural surgical plane, but the relationship …

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Postoperative Considerations Following Pituitary Surgery: A Guide for Clinicians

Erica Giraldi, Adriana G. Ioachimescu

Transsphenoidal surgery represents the primary treatment for pituitary adenomas (other than prolactin-secreting) and other sellar/suprasellar masses including craniopharyngiomas. Endocrine evaluation for anterior hypopituitarism and water metabolism disorders is indicated in all patients. Transient fluid restriction postoperatively in patients without vasopressin deficiency reduces …

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Langerhans Cell Histiocytosis With Hypothalamic-pituitary and Bone Involvement: A Report of 2 Cases

Erica Giraldi, Jason W. Allen, Morgan L. McLemore, Adriana G. Ioachimescu

Case 1: A 31-year-old woman presented with secondary amenorrhea, polyuria, and polydipsia. Three years later, magnetic resonance imaging of the brain done for headaches found thickening of the pituitary infundibulum. Laboratory evaluation indicated central vasopressin deficiency, mild hyperprolactinemia, and central hypogonadism. Six …

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Temporal Lobe Herniation and Chiasmopathy During Dopamine Agonist Therapy for Prolactinoma

Erica Giraldi

Background: Dopamine agonists (DA) are first line treatment for prolactinomas. Optic chiasm herniation can rarely occur during therapy, while brain herniation is very uncommon. Case Reports: A 34 yo woman presented with headaches and vision changes. Prolactin (PRL) was 4300 ng/mL. MRI …

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Pituitary Incidentalomas: Best Practices and Looking Ahead

Erica Giraldi, Jason W. Allen, Adriana G. Ioachimescu

Pituitary Incidentalomas (PI) are pituitary lesions serendipitously identified on imaging. PIs have become common in clinical practice because of increased use of imaging and radiologic advances. The most frequently incidentally detected lesions in adults are pituitary adenomas, followed by cystic lesions, and …

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Abstract #1160767: Frontal Lobe Herniation and New Chiasmopathy: Rare Complications of Dopamine Agonist Therapy in Large Prolactinomas

Erica Giraldi, Amit M. Saindane, Gustavo Pradilla, Adriana G. Ioachimescu

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Telemedicine for Neurosurgery Consultations at a Pituitary Center of Excellence: Patient Preference and Willingness to Proceed with Surgery

Alexander Greven, James Miller Douglas, Jordan Couceyro, Anudeep Nakirikanti et autres

Abstract Objective The purpose of this study was to evaluate pituitary tumor patient satisfaction with telemedicine, patient preference for telemedicine, potential socioeconomic benefit of telemedicine, and patients' willingness to proceed with surgery based on a telemedicine visit alone. Method In total, 134 …

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Functioning Crooke Cell Adenomas: Case Series and Literature Review

Erica Giraldi, Stewart G. Neill, Pia R. Mendoza, Amit M. Saindane et autres

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