Thyrotropin-secreting pituitary adenomas: diagnosis and management of patients from one Chinese center.
OBJECTIVE
Thyrotropin-secreting pituitary adenoma (TSHoma) is rare and it is also a rare cause of thyrotoxicosis. Failure to detect the presence of TSHoma may result in dramatic consequences. This study is a review of our experience in the management of TSHoma at Huashan Hospital, China.


METHODS
We followed up eight patients with TSHoma (five males and three females) between 2006 and 2011. The patients' medical records were retrieved, and the demographic data, clinical presentation and management, final outcomes and follow-up were reviewed, and surgery performed.


RESULTS
All the eight patients had unsuppressed TSH levels with elevated thyroid hormone levels; and neuroimaging revealed pituitary lesions. Five patients (62.5 %) were previously misdiagnosed as primary hyperthyroidism. They received pituitary adenomectomy, somatostatin analogs, and/or radiotherapy after definitive diagnosis. Serum TSH and thyroid hormone levels of all the patients restored to the normal levels during the follow-up.


CONCLUSIONS
Adenomectomy is not curative in many TSHoma patients, it should be adjuvantly treated by pharmacological and/or radiotherapy, frequently. A combination of adenomectomy, somatostatin analogs, and radiotherapy is often required for long-term management of the disease.
Institute of Endocrinology, Metabolism and Diabetology, Huashan Hospital, No. 12 Wulumuqi Middle Road, Shanghai, China.
Weiwei
W
Zhao
Hongying
H
Ye
Yiming
Y
Li
Linuo
L
Zhou
Bin
B
Lu
Shuo
S
Zhang
Jie
J
Wen
Shiqi
S
Li
Yehong
Y
Yang
Renming
R
Hu
D000236:Adenoma / Q000175:diagnosis* / Q000378:metabolism / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007016:Hypophysectomy; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000628:therapy*; D020266:Radiotherapy, Conformal; D013972:Thyrotropin / Q000378:metabolism*; D016896:Treatment Outcome; D055815:Young Adult
D000970:Antineoplastic Agents; D013972:Thyrotropin