Thyroid-stimulating hormone (thyrotropin)-secretion pituitary adenoma in an 8-year-old boy: case report

Abstract

In this report, an extremely rare case of pediatric thyrotropin-secreting pituitary macroadenoma (TSHoma) is described. An 8-year-old boy, complaining of unsteady gait, was suspected of endocrinopathy because of emaciation and muscle weakness of the legs. Endocrinological work-up established a diagnosis of hyperthyroidism due to syndrome of inappropriate secretion of TSH. Magnetic resonance imaging showed a pituitary macroadenoma with suprasellar and sphenoidal extension without cavernous sinus invasion. He underwent an endoscopic endonasal transsphenoidal adenomectory due to the diagnosis of TSHoma. The adenoma was soft and it was totally removed. Histopathological staining confirmed diagnosis of TSHoma. Postoperative evaluation revealed a subnormal level of TSH (from 13-21 to 0.03 micro U/ml), normalization of alpha-subunit (from 10.0 to 0.09 ng/ml), and as a result, hypothyroidism. The boy left the hospital with oral levothyroxine that continued until 12 months of discharge. The present 8-year-old case is the youngest case to the best of our knowledge based on a bibliographical search. Reasons for endocrinological remission following adenomectomy are (1) correct diagnosis without delay: lack of cavernous sinus invasion, (2) soft and non-fibrous adenoma tissue, and (3) endoscopic technique with wide vision and illumination: safe even for a 8-year-old child. Early recognition/detection and pituitary-conserving adenomectomy can cure TSHoma and avoid long-term medical therapy and/or irradiation, which contribute to the best interests of patients with TSHoma.

Analysis of the correlation between lipotoxicity and pituitary-thyroid axis hormone levels in men and male rats

“…Finally, pituitary-adrenal axis hormones, including adrenocorticotropin (ACTH) and cortisol (COR), control the function of the adrenal gland and are essential for stress responses [13]. Abnormal hormone levels can lead to metabolic disorder and other diseases [14, 15]. Thus, maintaining normal pituitary axis hormone levels is very important for human health.…”

High‐Cholesterol Diet Disrupts the Levels of Hormones Derived from Anterior Pituitary Basophilic Cells

“…For example, TSH controls energy metabolism , FSH and LH are indispensable for reproduction , and ACTH participates in the stress response . Inappropriate hormonal output can lead to metabolic disorders, as well as disease , and so maintenance of normal anterior pituitary structure and function is necessary for human health.…”

Long-Term Follow-Up in a Male Patient with Micro-TSH-Oma Diagnosed at 8-Yr-Old

“…TSH-omas are rare in adults and to our knowledge our patient is one of the youngest children with hyperthyroidism due to TSH-oma ever reported. Other 13 children or adolescents described were 8-yr. or older (8 to 16yr) and had macroadenoma except a 13 yr-old girl who had microadenoma and a 15 yr-old girl whose tumor size was not decribed [7][8][9][10][11][12][13][14][15][16][17][18][19].…”

“…*Basal cortisol = 3.43 mg/dL(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19); urine density = 1005; ** Total testosterone = 106 ng/dL (<100); peak LH and FSH after GnRH = 1.1 and…”