Hyperthyroidism due to inappropriate secretion of thyrotropin in 10 patients

Wynne, Alan G.; Gharib, Hossein; Scheithauer, Bernd W.; Davis, D. H.; Freeman, Susan L.; Horváth, Éva

doi:10.1016/0002-9343(92)90009-z

Cited by 58 publications

(18 citation statements)

References 44 publications

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“…twice monthly, octreotide (300 mg/day s.c.)) were effective in normalizing thyroid secretion; TSH levels were reduced by more than 50% in all patients for a mean time of 24 months (range 7 -48). fT 3 and fT 4 normalized in all cases. The aSU hypersecretion was also well controlled by somatostatin analogs in patients nos 13 and 40.…”

Section: Treatment Of Pituitary Adenomasmentioning

confidence: 99%

The changing spectrum of TSH-secreting pituitary adenomas: diagnosis and management in 43 patients

et al. 2003

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Objective: Our aim was to report the recent changes in diagnosis and management of TSH-secreting pituitary adenomas. Methods: We retrieved 43 consecutive patients with TSH-secreting pituitary tumors (23 male and 20 female) among 4400 pituitary adenomas followed between 1976 and 2001 in six Belgian and French centers. Results: TSH was elevated in 18/43 and a subunit in 13/32 patients. In patients with intact thyroid ðn ¼ 30Þ; mean free tri-iodothyronine was 13.1 pmol/l (range 3.5-23) and mean free thyroxine was 38.4 pmol/l (range 10.2 -62.7). Hyperprolactinemia and acromegaly were associated in 9/43 and 8/43 cases. The number of associated hypersecretions was higher in macroadenomas than in microadenomas (Chi square = 11.2, P , 0:01). Two women had sporadic multiple endocrine neoplasia type 1-associated syndrome. The proportion of microadenomas versus macroadenomas was 1/11 (period 1974-1986) and 8/32 (period 1987 -2001). Bilateral petrosal sinus sampling, 111 In-pentreotide scintigraphy and ( 11 C)-L-methionine positron emission tomography scan confirmed diagnosis in four questionable microadenomas. Macroadenomas with extrasellar extension (31 cases) had a tendency to be medially located. Medical treatment with somatostatin analogs was initiated as first-line treatment in 26 patients. TSH levels were reduced by more than 50% in 23/26 cases. A tumoral shrinkage of more than 20% was observed in 5/13 cases. Surgery was performed in 36 patients. After 1 year, 21 of them (58.3%) met the criteria of surgical favorable outcome. Pituitary radiotherapy ðn ¼ 8Þ and somatostatin analogs allowed normalization in cases not cured by surgery. Conclusion: Ultrasensitive methods for TSH measurement led to an earlier recognition of TSH-secreting pituitary tumors. In this series, we observed that TSH-secreting pituitary tumors are today more frequently found at the stage of microadenomas, medially located, without associated hypersecretions and needing new exploration methods as compared with older series. This changing spectrum in the presentation of TSH-secreting pituitary tumors and the excellent response to somatostatin analogs has been accompanied by an improvement in the prognosis of the disease.

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Section: Treatment Of Pituitary Adenomasmentioning

confidence: 99%

The changing spectrum of TSH-secreting pituitary adenomas: diagnosis and management in 43 patients

et al. 2003

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“…After that, TSHoma reports were scarce in the literature. It was not until the 1980s that a few limited reports on the diagnosis of TSHomas were published (3,4,5,6,7,8). Subsequently, the diagnostic and therapeutic management of these rare pituitary adenomas has evolved substantially.…”

Section: Introductionmentioning

confidence: 99%

DIAGNOSIS OF ENDOCRINE DISEASE: Diagnostic approach to TSH-producing pituitary adenoma

Tjörnstrand

Nyström

2017

European Journal of Endocrinology

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Thyrotropin (TSH)-secreting adenomas (TSHomas) are the rarest form of pituitary adenomas, and most endocrinologists will see few cases in a lifetime, if any. In most cases, the diagnostic approach is complicated and cases may be referred after being presented as a syndrome of inappropriate TSH secretion or as a pituitary mass. This review aims to cover the past, present and possible future diagnostic approaches to TSHomas, including different clinical presentations, laboratory assessment and imaging advances. The differential diagnoses will be discussed, as well as possible coexisting disorders. By evaluating the existing reports and reviews describing this rare condition, this review aims to present a clinically practical suggestion on the diagnosic workup for TSHomas, Major advances and scientific breakthroughs in the imaging area in recent years, facilitating diagnosis of TSHomas, support the belief that future progress within the imaging field will play an important role in providing methods for a more efficient diagnosis of this rare condition.

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“…Au cours du bilan d'une pathologie hypophysaire : -devant des adé nomes hypophysaires mixtes sé cré tant en plus de la TSH de l'hormone de croissance (gigantisme ou acromé galie), et/ou de la prolactine (syndrome amé norrhé e-galactorrhé e chez la femme) ; -devant une insuffisance anté hypophysaire complè te ou un hypogonadisme ; -devant un syndrome tumoral hypophysaire marqué par des cé phalé es, une alté ration du champ visuel, plus rarement une atteinte de l'oculomotricité voire des signes d'hypertension intracrâ nienne ; -lors du bilan d'un « incidentalome » hypophysaire. Plus rarement lors du bilan d'une polyendocrinopathie de type MEN 1 [11], ou d'une maladie de MacCune-Albright [12].…”

Section: Signes Cliniquesunclassified

Adénomes hypophysaires à TSH ou adénomes thyréotropes

Caron¹

2009

La Presse Médicale

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Hyperthyroidism due to inappropriate secretion of thyrotropin in 10 patients

Cited by 58 publications

References 44 publications

The changing spectrum of TSH-secreting pituitary adenomas: diagnosis and management in 43 patients

The changing spectrum of TSH-secreting pituitary adenomas: diagnosis and management in 43 patients

DIAGNOSIS OF ENDOCRINE DISEASE: Diagnostic approach to TSH-producing pituitary adenoma

Adénomes hypophysaires à TSH ou adénomes thyréotropes

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