Hyperthyroidism Caused by an Ectopic Thyrotropin-Secreting Tumor of the Nasopharynx: A Case Report and Review of the Literature

Tong, Anli; Xia, Weibo; Fang, Qi; Jin, Zi-meng; Yang, Di; Zhang, Zhuhua; Li, Fang; Xing, Xiaoping; Lian, Xiaolan

doi:10.1089/thy.2012.0574

Cited by 31 publications

(27 citation statements)

References 17 publications

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“…Similarly, the inhibitory effect of octreotide was seen in ectopic TSH-oma too [5]. This patient presented a significant inhibitory response to octreotide (Figure 2B), and the inhibitory effect of octreotide on ectopic TSH-oma cells was also confirmed in vitro [5]. In addition, TSH-secreting tumor cells possessed dopamine receptors.…”

Section: Discussionmentioning

confidence: 63%

“…FT3 and FT4 levels decreased markedly following delivery of somatostatin analogues in all TSH-omas but not RTH patients [12]. Similarly, the inhibitory effect of octreotide was seen in ectopic TSH-oma too [5]. This patient presented a significant inhibitory response to octreotide (Figure 2B), and the inhibitory effect of octreotide on ectopic TSH-oma cells was also confirmed in vitro [5].…”

Section: Discussionmentioning

confidence: 84%

“…The adenoma consisted of monomorphous cells as visualized by electron microscopy. Numerous secretory granules were scattered across the cytoplasm or along the cell membrane [5]. They were similar in size and shape of electron dense with a diameter of 60-120 [5].…”

Section: Discussionmentioning

confidence: 99%

“…Numerous secretory granules were scattered across the cytoplasm or along the cell membrane [5]. They were similar in size and shape of electron dense with a diameter of 60-120 [5]. In comparison, the tumor cells of this case were pleomorphic, and the size of their electron dense granules was larger with a diameter of 100-200 nm, and were scattered or clustered in the cytoplasm.…”

Section: Discussionmentioning

confidence: 99%

“…Ectopic TSH-oma is extremely rare. Since the first description of the disease by Cooper and colleagues in 1996, only four cases have been reported to date [2–5]. Here a newly identified case is reported, and the clinical and laboratory features of previous published cases are reviewed.…”

Section: Introductionmentioning

confidence: 96%

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Ectopic TSH-secreting pituitary tumor: a case report and review of prior cases

Song

Wang

Li³

et al. 2014

BMC Cancer

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BackgroundEctopic TSH-secreting pituitary adenoma (TSH-oma) is a very unusual disorder. To date, there are only four cases reported. It is difficult to distinguish ectopic cases from both regular TSH-omas and resistance to thyroid hormone (RTH).Case presentationA newly identified case of ectopic TSH-oma arising from the nasal pharynx was described, and reports of four prior cases were reviewed. The patient was a 41-year-old male who developed what appeared to be typical hyperthyroidism and atrial fibrillation in 2009. Thyroid function tests showed elevated basal levels of free T3 (FT3, 24.08 pmol/L), free T4 (FT4, 75.73 pmol/L), and serum TSH (7.26 μIU/ml). Both TSH-oma and resistance to thyroid hormone syndrome were considered. TRH stimulating test was negative, whereas octreotide inhibition test showed a reduction in TSH by 30.8%. Furthermore, a large space-occupying lesion located at the nasopharynx was found by computed tomography and magnetic resonance imaging (MRI). A normal pituitary was visualized. Ectopic TSH-oma was preliminarily established. Using an endoscopic endonasal approach, the tumor was resected. Histological features and immunophenotypes were consistent with those of TSH-secreting tumor. The levels of both free thyroxine and TSH returned to normal ranges the day after surgery and remained within normal range for 48 months.ConclusionsAlthough exceedingly rare, ectopic TSH-oma should be considered for patients with inappropriate secretion of TSH with hyperthyroidism and pituitary tumor undetectable by computed tomography and MRI. To our knowledge, this is the first case followed up more than 4 years. The characteristics and successful interventions summarized in this report provide a guideline for clinicians.

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Section: Discussionmentioning

confidence: 63%