The outcome of TSHoma from a tertiary care institute in India

Abstract

Background: Thyroid-stimulating hormone (TSH)-secreting pituitary adenoma (TSHoma) is the rarest functioning pituitary adenoma. Methods: A retrospective analysis of eight patients of TSHomas to highlight the presentations, diagnostic challenges, and treatment outcomes. Results: Median age at diagnosis was 42 years, median latency to diagnosis was 2.5 years, and thyrotoxic and compressive symptoms were the most common presenting symptoms. At presentation, three cases were plurihormonal, six cases were on medical treatment including thyroxine, and two cases were incidentally discovered. Imaging revealed macroadenoma in all cases. Seven cases underwent pituitary surgery, after which three achieved remission. Another case entered remission after adjunctive radiotherapy. Thyrotropin (TSH) immunostaining was demonstrated in six out of seven adenomas. Conclusion: TSHoma is a rare functioning pituitary tumor with both silent and symptomatic presentations. Diagnosis can be established with biochemical and imaging features, even without dynamic tests.

Gonadotropin-secreting and thyrotropin-secreting pituitary adenomas: A single-center experience

“…The higher rate of residual disease and need for second-line therapy by the patients with TSHomas in our cohort may be due to larger tumors with frequent parasellar extension. Notably, another Indian study has also reported a lower remission rate ( 28 ).…”

Clinicopathologic Features in a TSH Secreting Pituitary Tumor : a Case Report

“…This shift has led to an increased diagnosis of patients who exhibit normal or elevated TSH levels, alongside elevated concentrations of free thyroid hormones. 4,5 Conversely, magnetic resonance imaging (MRI) examinations have gained popularity, increasing the likelihood of incidentally discovering pituitary tumors. 6 Patients with resistance to thyroid hormones (RTH) may also exhibit signs and symptoms of hyperthyroidism.…”