Treatment of a thyrotropinoma with octreotide-LAR in a patient with multiple endocrine neoplasia-1.
OBJECTIVE
To note that a thyrotropin (TSH)-secreting macroadenoma may be part of the multiple endocrine neoplasia-1 (MEN-1) syndrome and to report the use of octreotide-LAR (OCT-LAR) to treat a TSH-secreting macroadenoma in a patient with MEN-1 with previous surgery for hyperparathyroidism and gastrinoma.


METHODS
We present a patient with a TSH-secreting pituitary macroadenoma and report the results of her endocrine, genetic, radiologic, and nuclear medicine testing and her response to treatment with octreotide (OCT), octreotide-LAR, and estrogen.


RESULTS
This patient's TSH-induced hyperthyroidism responded to octreotide for 5 months and octreotide-LAR for more than 11 months. Her hypercalcemia normalized while she was taking estrogen. Her genetic testing is reported to show a genetic defect that is typical of patients with MEN-1.


CONCLUSIONS
This report describes: (1) The use of octreotide-LAR to treat both a TSH-secreting pituitary tumor and a gastrinoma over 12 months; (2) the importance of including these tumors into the MEN-1 syndrome with its attendant implications; and (3) a genetic defect, typical of patients with MEN-1, associated with this tumor.
Taylor
T J
TJ
Diabetes and Metabolic Disease Center, Christiana Health Systems, Wilmington, Delaware, USA. rathmines2@yahoo.com
Donlon
S S
SS
Bale
A E
AE
Smallridge
R C
RC
Francis
T B
TB
Christensen
R S
RS
Burma
K D
KD
D000236:Adenoma / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000378:metabolism; D004967:Estrogens / Q000008:administration & dosage; D005260:Female; D006728:Hormones / Q000008:administration & dosage*; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology; D006980:Hyperthyroidism / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology; D008875:Middle Aged; D018761:Multiple Endocrine Neoplasia Type 1 / Q000000981:diagnostic imaging / Q000188:drug therapy*; D015282:Octreotide / Q000008:administration & dosage*; D011877:Radionuclide Imaging; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000378:metabolism; D013972:Thyrotropin / Q000378:metabolism*
D004967:Estrogens; D006728:Hormones; D013972:Thyrotropin; D015282:Octreotide