"How You Can Help" Information on the MGH Neuroendocrine Clinical Center and Pituitary Tumor Center Voice: 617.726.7948 Fax: 617.726.1241 Best Hospitals: Neurology & Neurosurgery Introduction Attending Staff Scheduling Outpatient Services Inpatient Consultation Service Special Expertise Stereotactic Proton Radiosurgery Neuroendocrine Speakers Bureau Neuroendocrine Clinical Conferences Neuroendocrine Lecture Series Neuroendocrine Research Studies Physicians' Pituitary  Information Service Physicians with questions may contact:  DR Biller or DR Klibanski at 617.726.3965 or 1.888.429.6863 e-mail pituitary.info@partners.org

Profiles of the Endocrine Clinic: A Decade of the Massachusetts General Hospital Neuroendocrine Clinical Center.

The Neuroendocrine Clinical Center provides a multidisciplinary approach to patients with pituitary and hypothalamic disorders. Endocrinologists, Neurologists, and Neurosurgeons participate in the management of such patients. The Center is a national referral center for the evaluation and treatment of pituitary tumors, recurrent pituitary adenomas, and tumors or disorders of the hypothalamic-pituitary region. The Center is ideally suited for the referral of patients with pituitary tumors, including prolactinomas, Cushing's disease, acromegaly, nonfunctioning pituitary tumors, recurrent pituitary adenomas, and pituitary and hypothalamic disorders which lead to adrenal, thyroid, ovarian, or testicular deficiency. Patients can be referred for the development of a treatment plan in conjunction with their primary physician, for a second opinion, or for ongoing management by the Center physicians.

• Endocrinologists in the Center are experienced in the chronic administration of replacement hormones and in the use of drugs which block hormone excess syndromes. They are experienced in the use of investigational drugs for the treatment of prolactin and growth hormone disorders. They have been at the forefront of medical therapy for pituitary disorders with the use of new dopamine agonists for prolactinomas and somatostatin analogues for acromegaly.
• Neurosurgical involvement in the Center ensures prompt surgical intervention when necessary.
• Input from the Department of Radiation Medicine facilitates the planning of therapy.
• Neurologists are available for the pharmacological treatment of headaches, seizures, and hypothalamic syndromes.
• The Neuroendocrine Clinical Nurse offers patient education, including teaching self-administration of medications requiring injection.

Scheduling and Referrals: The Massachusetts General Hospital Neuroendocrine Clinical Center is located on the lst floor (Suite 112) of Zero Emerson Place, Boston, Massachusetts, (off Blossom Street) and directly across from the Massachusetts General Hospital Gray Lobby. (Select here for maps of MGH). Outpatient clinical visits and inpatient consultations can be arranged by calling the Neuroendocrine Clinical Center Office at (617) 726-7948. Physicians with questions may contact Dr. Biller or Dr. Klibanski at (617) 726-3965.

Special Instructions (If available, please bring):

• Copies of your medical records/discharge summary/physician notes
• a copy of your X rays
• a copy of your lab reports
• If you are presently under medications, bring them with you to your appointment
• Reminder: Please bring your current blue hospital card to your appointment. If you do not have a card or your card needs to be updated, please go to one of the registration areas at least 20 minutes prior to your appointment. Thank you.

Outpatient Service

Diagnosis

The Neuroendocrine Clinical Center offers detailed outpatient evaluation of all disorders affecting the endocrine function of the hypothalamus and pituitary gland, achieved through comprehensive office visits, complete basal and dynamic hormone testing, and coordination of radiological studies and visual field evaluations. All new patients are presented at the weekly Neuroendocrine Clinical Conference which is attended by endocrinologists, neurosurgeons, neurologists, and radiation therapy physicians. A diagnostic and therapeutic plan is formulated for each patient and provided to the referring physician.

Special Expertise

Areas in which the Neuroendocrine Clinical Center provides special multidisciplinary expertise include:

• Pituitary Tumors
  • Prolactinomas; Cushing's disease; Acromegaly; Non-functioning tumors; Recurrent pituitary adenomas.
• Prolactin Disorders
  • Amenorrhea-Galactorrhea Syndrome; Drug-induced hyperprolactinemia; Infertility; Male hypogonadism.
• Cushing's Disease
  • Pituitary Cushing's; Ectopic Cushing's; Adrenal Cushing's; Iatrogenic Cushing's, Recurrent Cushing's.
• Hypopituitarism
  • Hypoadrenalism; Hypothyroidism; Hypogonadism; Growth hormone deficiency.
• Posterior Pituitary Dysfunction
  • Diabetes insipidus; Syndrome of inappropriate antidiuretic hormone secretion.
• Hormone Dependent Neurologic Disorders
  • Seizures; Headaches.
• Hypothalamic Syndromes
  • Suprasellar Tumors; Craniopharyngiomas

Stereotactic Proton Radiosurgery

An innovative program utilizing proton beam therapy and conventional radiation therapy for treatment of pituitary lesions. Laser-guided MR imaged stereotactic intrasellar tumor localization can be used for selected patients with untreated pituitary tumors, incomplete surgical resection, or tumor recurrence.

Speakers

The Neuroendocrine Clinical Center offers speakers on a wide variety of topics. Lectures, rounds, and small symposia can be arranged.

Neuroendocrine Clinical Conference

A weekly interdisciplinary conference is held to discuss all new patients referred to the Neuroendocrine Clinical Center and to review patient management issues. It is a multidisciplinary conference, attended by the members of the Neuroendocrine, Neurology, Neurosurgery, and Radiation Medicine services. Physicians are welcome to attend and present cases.

Neuroendocrine Lecture Series

A bimonthly conference is held on didactic and research topics related to Neuroendocrinology. Attendance at this series is open to all interested medical personnel.

Research Studies Available

Patients may qualify for research studies in the Neuroendocrine Clinical Center.  We are currently accepting the following categories of patients for screening to determine study eligibility.  Depending on the study, subjects may receive free testing, medication and/or stipends. [ see Neuroendocrine Links for more information ]

SUBJECTS	STUDIES	CONTACT  617-726-3870
Newly diagnosed acromegaly patients	·  Evaluating preoperative medical treatments	Karen Pulaski-Liebert, R.N. Dr. Beverly M.K. Biller
Patients with Cushing’s Syndrome	·  Evaluating a potential new medical therapy (Anticipated Start: Winter 2006)	Karen Pulaski-Liebert, R.N. Dr. Beverly M.K. Biller
Patients with history of cured acromegaly with or without hypopituitarism	·  Body composition and cardiovascular evaluation ·  GH replacement study in patients with GH deficiency	Dr. Anne Klibanski Dr. Karen K. Miller
Women with anorexia nervosa	·  New therapies	Dr. Karen K. Miller Dr. Anne Klibanski
Adolescent girls with anorexia nervosa	·  Evaluating bone density and the effects of estrogen replacement	Dr. Anne Klibanski Dr. Madhu Misra
Healthy adolescent girls and boys	To determine extent of growth hormone suppression following an oral glucose load	Dr. Anne Klibanski Dr. Madhu Misra
Healthy and overweight adolescent girls, ages 12-18	Investigating body weight in relation to GH and ghrelin secretion in adolescents	Dr. Anne Klibanski Dr. Madhu Misra
Women and adolescent girls with anorexia nervosa	·  Investigating effects of rhGH on bone metabolism	Dr. Anne Klibanski Dr. Madhu Misra Dr. Rajani Prabhakaran
Women, ages 18-45	·  Investigating body weight and GH secretion GH treatment in abdominal obesity	Dr. Andrea Utz Dr. Karen K. Miller
Healthy women, ages 18-45	·  Investigating body weight in relation to GH and ghrelin secretion in adolescents	Dr. Anne Klibanski Dr. Madhu Misra Dr. Patrika Tsai
Healthy women, ages 18-45	·  Investigating the link between cortisol regulation and bone density	Dr. Elizabeth Lawson Dr. Karen K. Miller Dr. Anne Klibanski
Women with irregular menstrual periods (hypothalamic amenorrhea), ages 18-45	· Investigating the link between cortisol regulation and bone density	Dr. Elizabeth Lawson Dr. Karen K. Miller Dr. Anne Klibanski
HIV positive women with reduced testosterone levels	·  Evaluating effects of testosterone therapy	Dr. Steven Grinspoon Sara Dolan Looby, N.P.
HIV positive men and women with fat redistribution	·  Evaluating effects of testosterone therapy	Dr. Steven Grinspoon Sara Dolan Looby, N.P.
HIV positive men and women with fat redistribution	·  Novel treatments to redistribute fat ·  Novel lipid lowering therapy	Dr. Steven Grinspoon
HIV positive men and women	·  Use of GHRH, a growth hormone secreta with fat redistribution gogue, to increase endogenous GH levels, improve fat distribution and lipid profile ·  Among patients with reduced GH response to standard GH secretion testing, use of low dose GH as above	Dr. Steven Grinspoon

Facilities

The Massachusetts General Hospital Neuroendocrine Clinical Center is located on the lst floor (Suite 112) of Zero Emerson Place, Boston, Massachusetts, (off Blossom Street) and directly across from the Massachusetts General Hospital Gray Lobby. (Select here for maps of MGH). Outpatient clinical visits and inpatient consultations can be arranged by calling the Neuroendocrine Clinical Center Office at (617) 726-7948. Physicians with questions may contact Dr. Biller or Dr. Klibanski at (617) 726-3965.
• Facilities include: Examination rooms; Conference area; Pituitary Test Center; 3-bed area for dynamic hormone testing.
• Physician or Nurse is available for: IV insertion; Administration of testing agents; Patient monitoring.
• Technician present for: Precisely timed blood sampling; Hand delivery of samples to the laboratory.
• Available tests include: ACTH (Cortrosyn) stimulation; Insulin tolerance; CRH stimulation; TRH stimulation; GnRH stimulation; Oral glucose tolerance; Growth hormone reserve testing.
• The Pituitary Center can arrange for complete outpatient or in-patient diagnostic testing for Cushing's syndrome, including bilateral inferior petrosal sinus ACTH sampling which is considered the definitive test for Cushing's disease in patients without tumors visible on head scans.

Inpatient Consultation Service

The staff is available for inpatient consultations related to neuroendocrine disorders. All patients are followed for diagnostic evaluation or hormone management as required.

"How You Can Help"

Donations to the Neuroendocrine Educational and Training Fund may be sent to the MGH Development Office, Massachusetts General Hospital, 100 Charles River Plaza, Suite 600, Boston, MA 02114-2792, (phone 617-726-2200).

Checks should be made payable to the Neuroendocrine Educational and Training Fund at Massachusetts General Hospital, and will be added to the Neuroendocrine Educational and Training Fund.

You may also make a gift through the MGH Giving website (or online directly via secure web site). When making a gift on line, indicate the designation as "Other, MGH Neuroendocrine Educational and Training Fund."

Physicians' Pituitary Information Service Physicians with questions may contact Dr Biller or DR Klibanski at 617.726.3965 or 1.888.429.6863 or via e-mail pituitary.info@partners.org Physicians with questions may contact Dr. Biller or Dr. Klibanski at 617-726-5002 or 800-353-9460.