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Leslie Snyder - Pituitary Tumor

​The Challenge

It was almost Christmas. Leslie Snyder’s vision had been blurry, but she was busy and didn’t go to the doctor right away. She was working full-time as a managing director for her company, her husband was recovering from surgery, and she got the flu. Add in the bustle of the holiday season, and Leslie didn’t have time to think about anything else.

But her vision only got worse. Soon, it was affecting her ability to do her work – which requires extensive reading and writing on a computer. So, she went to the eye doctor.

“I honestly thought it was a bad batch of contacts,” Leslie says.

But it wasn’t. Leslie’s ophthalmologist gave her a visual field test and discovered that she couldn’t use her full field of vision, especially in her right eye. She was told to come back in a week for another test. By the time Leslie returned, her vision had deteriorated further. She was having headaches, needed to zoom in dramatically on her computer to read, and frequently had to go home and nap after work. Suspecting a serious issue, the doctor sent Leslie for an MRI. His suspicions were confirmed: the scan revealed a very large tumor on the pituitary gland, which is located at the base of the brain, with severe compression of the optic apparatus and invasion into the cavernous sinus, one of the most difficult-to-access areas in the human head.

The Path to UPMC

Leslie began learning more about her condition by conducting an Internet search. As a resident of the South Hills of Pittsburgh, she was aware of UPMC’s reputation for having specialists who employ cutting-edge surgical treatments. When she found Juan C. Fernandez-Miranda, MD, associate professor of Neurosurgery and associate director of the UPMC Center for Skull Base Surgery, she didn’t hesitate to make an appointment.

Leslie met with Dr. Fernandez-Miranda, who showed her pictures of the tumor and walked her through what she could expect from surgery, recovery, and follow-up. Given her progressive visual decline, Dr. Fernandez-Miranda scheduled her surgery for one week later.

“He made me feel like he genuinely cared about me,” Leslie says. “I felt like I was in excellent hands after that first meeting.”

The Solution

For Leslie, the first wave of relief came when Dr. Fernandez-Miranda put a name to her condition and said, “I know how to fix this.” The second came when she learned that he would be using a minimally invasive surgical procedure called the Endoscopic Endonasal Approach (EEA).

Dr. Fernandez-Miranda worked with Eric Wang, MD, an ear, nose and throat specialist at UPMC, to treat Leslie. By using EEA, a technique pioneered at UPMC, they removed Leslie’s tumor through her nose with no facial incisions. They were able to remove the tumor completely, even the most complex portion of the tumor invading the cavernous sinus. EEA, when performed by highly experienced surgeons, allows them to access hard-to-reach areas of the brain and base of the skull, like the pituitary gland, and successfully remove tumors that would have once been inoperable.

The Results

Following surgery, Leslie’s eyesight returned to normal and she experienced no side effects. With follow-up scans and tests revealing no remaining trace of the tumor, Leslie quickly returned to her busy, active lifestyle. Less than a year after having her tumor removed, she traveled abroad to spend several weeks in Vietnam, a trip that would not have been possible without the surgery.

Leslie has continued to meet with Drs. Fernandez-Miranda and Wang during her recovery period. She says both physicians made her feel hopeful about her prognosis and recovery and helped her realize that she had done the right thing by finding them.

Reflecting on her experience at UPMC, Leslie says, “I just feel so blessed to be in Pittsburgh and to have access to this quality of care.”

Our patient stories profile a number of patients who have had minimally invasive brain surgery at UPMC. Although everyone's care experience is unique, we hope that sharing these stories will help other prospective patients and their families better understand these procedures and their potential benefits.

Leslie's treatment and results may not be representative of all similar cases.


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