title: Thyrotropin secreting pituitary adenoma accompanying a silent somatotropinoma.
abstract: Thyroid stimulating hormone (TSH) secreting pituitary adenomas are rare tumors manifested as hyperthyroidism with goiter in the presence of elevated TSH. We present a case with pituitary adenoma secreting both TSH and growth hormone (GH) with the prominent clinical findings of hyperthyroidism but without clinical findings of acromegaly. Pituitary magnetic resonance imaging revealed a macroadenoma. Transsphenoidal surgery was performed twice. The immunohistochemical staining showed that tumor cells were strongly reactive to GH and relatively mildly reactive to TSH. Control pituitary imaging revealed a residual macroadenoma, and long acting octreotide treatment was administered. After two years of the treatment, tumor size remained the same while thyroid function tests and insulin-like growth factor 1 (IGF-I) values returned to normal ranges. In conclusion, we always recommend hormonal examinations for all patients who have pituitary adenoma without signs and symptoms of acromegaly.
authors.affiliation: Ministry of Health, Ankara Numune Research and Training Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey. dberker6@yahoo.com
authors.forename: Dilek
authors.initials: D
authors.lastname: Berker
authors.forename: Serhat
authors.initials: S
authors.lastname: Isik
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Aydin
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Tutuncu
authors.forename: Gokhan
authors.initials: G
authors.lastname: Akdemir
authors.forename: Hatice Nursun
authors.initials: HN
authors.lastname: Ozcan
authors.forename: Serdar
authors.initials: S
authors.lastname: Guler
mesh_terms: D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D006728:Hormones / Q000097:blood; D006801:Humans; D006980:Hyperthyroidism / Q000209:etiology; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D008297:Male; D019635:Neurosurgical Procedures; D015282:Octreotide / Q000627:therapeutic use; D010902:Pituitary Gland / Q000473:pathology; D013100:Sphenoid Bone / Q000601:surgery; D013960:Thyroid Function Tests; D013972:Thyrotropin / Q000378:metabolism*
chemical_list: D018931:Antineoplastic Agents, Hormonal; D006728:Hormones; D007334:Insulin-Like Growth Factor I; D013972:Thyrotropin; D015282:Octreotide