title: Management of a pregnant woman with thyrotropinoma: a case report and review of the literature.
abstract: BACKGROUND
  Pituitary disorders during pregnancy are uncommon. The approach should include a close follow-up in order to reduce maternal and fetal risks associated with physiological changes during pregnancy or treatment side effects.
  
  
  METHODS
  We report a 21-year-old woman with a thyroid-stimulating hormone-secreting pituitary macroadenoma and positive antithyroid antibodies. She was initially treated using transsphenoidal pituitary surgery. The patient relapsed 17-month post-surgery. Somatostatin analog therapy was started which rapidly controlled the hyperthyroidism. Eleven months later, while receiving octreotide, the patient reported to be pregnant and the medication was stopped. Gestation and delivery went well with a healthy full-term newborn. The patient developed a postpartum thyroiditis 15 weeks after giving birth. Twenty-eight months postpartum the patient remains euthyroid without medication.
  
  
  CONCLUSIONS
  The overall positive outcomes of the four cases reported in literature, including this new case, suggest that pregnancy should not be absolutely contraindicated in women with thyrotropinomas. We emphasize the effectiveness of octreotide to control hyperthyroidism, as well as stopping medication when a patient is found to be pregnant. In our case, close observation following octreotide cessation had a positive outcome.
authors.affiliation: a Department of Endocrinology and Nutrition , Clínica Universidad de Navarra, University of Navarra , Pamplona , Spain.
authors.forename: Carolina M
authors.initials: CM
authors.lastname: Perdomo
authors.affiliation: b Department of Pathological Anatomy , Clínica Universidad de Navarra, University of Navarra , Pamplona , Spain , and.
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Árabe
authors.affiliation: b Department of Pathological Anatomy , Clínica Universidad de Navarra, University of Navarra , Pamplona , Spain , and.
authors.forename: Miguel Á
authors.initials: MÁ
authors.lastname: Idoate
authors.affiliation: a Department of Endocrinology and Nutrition , Clínica Universidad de Navarra, University of Navarra , Pamplona , Spain.|c IdiSNA (Instituto de investigación en la Salud de Navarra) , Pamplona , Spain.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Galofré
mesh_terms: D000236:Adenoma / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery; D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D003131:Combined Modality Therapy / Q000009:adverse effects; D016903:Drug Monitoring; D005260:Female; D006801:Humans; D006980:Hyperthyroidism / Q000209:etiology / Q000517:prevention & control; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000503:physiopathology; D018365:Neoplasm, Residual; D015282:Octreotide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D059351:Organ Sparing Treatments / Q000009:adverse effects; D010902:Pituitary Gland / Q000187:drug effects* / Q000378:metabolism / Q000601:surgery; D010911:Pituitary Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000188:drug therapy* / Q000503:physiopathology; D047929:Term Birth; D013972:Thyrotropin / Q000378:metabolism; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018931:Antineoplastic Agents, Hormonal; D013972:Thyrotropin; D015282:Octreotide
keywords: Pituitary tumors; pregnancy; thyrotropinoma