Kristina Kaliontgis
UF surgeons remove patient's brain tumor through nose
Kristina Kaliontgis started experiencing severe headaches in March 2008, so she scheduled an appointment with her primary care physician for further evaluation. A year later, she was diagnosed with acute migraines. They were so unbearable that prescription medications offered her no relief and an MRI was ordered.
What was found on the MRI was shocking. She was diagnosed with a pituitary macroadenoma (a tumor of the pituitary gland). The pituitary gland is the size of a pea and is located at the base of the skull between the optic nerves.
"My diagnosis was very surprising," she said. "Never did I think something as serious as this would happen. Until then, I had been relatively healthy."
Kaliontgis, 20, was the first person in her family to be diagnosed with any form of cancer. She immediately called her parents because she had gone to her appointment alone.
"I was sitting in the doctor's office and overheard them say ‘we need to get a neurosurgeon on the phone immediately,'" Kaliontgis said. "I was very scared and I started to cry."
She was referred to Michael Petr, MD, a University of Florida College of Medicine-Jacksonville assistant professor of neurosurgery, and Iman Naseri, MD, a UF College of Medicine-Jacksonville assistant professor of otolaryngology at Shands Jacksonville.
The minimally invasive procedure
On Dec. 18, 2009, Kaliontgis underwent a three-hour operation.
During the surgery, Naseri provided minimally invasive access to the tumor so that Dr. Petr could remove it.
Petr opened the floor of the skull and removed the tumor, located at the base of the brain.
"The uniqueness of our surgery is from the approach through the nose with no incisions rather than the standard incision under the upper lip and lifting the lip and nose off the facial bones to access the tumor," Petr said. "The procedure does not cause any facial tissue injuries, no swelling and no significant discomfort."
The procedure, which is performed regularly at Shands Jacksonville, offers much faster recovery time than traditional more invasive operations. Kaliontgis stayed in the hospital for five days and discharged on Dec. 23, 2009.
"Christina went on vacation days after surgery and returned to work and college in a couple of weeks," Petr said.
Patients who have this procedure normally remain hospitalized for a couple of days to have their hormone levels monitored. The operation requires special surgical instruments, skilled physicians and advanced technology.
Petr said 10 percent of the population in the United States have pituitary tumors and do not know it, and in some cases they do not need to be treated. However, in Kaliontgis' case her tumor was a macro-adenoma (greater than 1cm in diameter), which elevated and compressed the optic nerves and placed her vision at risk. Although her blood hormone levels were normal, her tumor pathology report showed that it could have caused long term health risks to other parts of her body.
A happy ending
Kaliontgis said since having the operation she no longer has migraines. She has returned to work at Lowe's and is finishing her bachelor's degree in elementary education. She said she is grateful for the care she received by UF physicians and Shands nurses.
"My physicians were the best," Kaliontgis said. "They truly cared about my wellbeing and for me as a patient. I was blessed to have both of them as my doctors."
It's been seven months since her surgery and she said she is feeling much better. Kaliontgis continues to see both Petr and Naseri for follow-up care.
"I certainly do consider her healthy and she has completely recovered," Naseri said.
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