TSH-secreting pituitary adenomas: follow-up of 11 cases and review of the literature.
Thyrotropin (TSH)-secreting pituitary adenomas account for less than 1% of all pituitary tumors. In the last two decades, their clinical management has changed markedly due to technological advances that made earlier diagnosis possible and the introduction of somatostatin analog therapy. We retrieved the data of 11 patients in Israel diagnosed with TSH-secreting pituitary tumors since 1989. There were six men and five women of mean age 44.8 +/- 19.5 years (range 18-80 years). All had elevated thyroxine and triidothyronine levels with nonsuppressed TSH and imaging evidence of a pituitary tumor. In three patients the tumor co-secreted growth hormone. Ten patients had macroadenomas (> or =10 mm) and one patient had a microadenoma (<10 mm). Nine patients underwent surgery, and all had postoperative evidence of residual tumor. Ten patients received long-term somatostatin analog therapy (9 postoperatively, 1 primarily), which controlled the hyperthyroidism in all of them. In addition, three patients showed tumor shrinkage and seven, stabilization of tumor growth.In conclusion, in patients with TSH-secreting pituitary adenomas, somatostatin therapy appears to be highly effective in treating hyperthyroidism and in halting tumor growth or promoting tumor shrinkage.
Ness-Abramof
Rosane
R
Endocrinology, Sapir Medical Center, Tchernikovsky 53, Kfar Saba 44262, Israel. rosane-abramof.ness@clalit.org.il
Ishay
Avraham
A
Harel
Gideon
G
Sylvetzky
Noa
N
Baron
Elzbieta
E
Greenman
Yona
Y
Shimon
Ilan
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006727:Hormone Antagonists / Q000627:therapeutic use; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000601:surgery; D013004:Somatostatin / Q000031:analogs & derivatives / Q000627:therapeutic use; D013972:Thyrotropin / Q000097:blood / Q000378:metabolism*; D013974:Thyroxine / Q000097:blood; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014284:Triiodothyronine / Q000097:blood
D018931:Antineoplastic Agents, Hormonal; D006727:Hormone Antagonists; D014284:Triiodothyronine; D013004:Somatostatin; D013972:Thyrotropin; D013974:Thyroxine