Thyrotropin-secreting pituitary adenomas: a systematic review and meta-analysis of postoperative outcomes and management

Cossu, Giulia; Daniel, Roy Thomas; Pierzchała, Katarzyna; Berhouma, Moncef; Pitteloud, Nelly; Lamine, Faïza; Colao, Annamaria; Messerer, Mahmoud

doi:10.1007/s11102-018-0921-3

Cited by 45 publications

(67 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This can be used to complement subsequent genetic studies if this diagnosis is suspected. Conversely, in TSHoma, an attenuated or absent TSH response is seen, but with generally less than a 1.5-fold rise in TSH from baseline in macroadenomas, although a greater response may paradoxically be seen with microadenomas [7][8][9][10][11][12].…”

Section: Resistance To Thyroid Hormonementioning

confidence: 97%

“…The majority (approximately two-thirds) demonstrate invasion into local structures at the time of diagnosis. While between 70 and 80% of these tumors secrete only TSH, approximately 25% are mixed and co-secrete growth hormone or prolactin [9][10][11][12]. In such cases, hypersecretion of these other anterior pituitary hormones may dominate the clinical picture.…”

Section: Tsh-secreting Pituitary Adenomamentioning

confidence: 99%

“…Visual field defects should be sought and formal visual field testing should be undertaken given the propensity of these tumors to be large and locally invasive at diagnosis. Hypogonadotrophic hypogonadism may also rarely be present and in females, oligomenorrhea or amenorrhea may be present [5,8,9].…”

Section: Tsh-secreting Pituitary Adenomamentioning

confidence: 99%

“…The treatment of choice is transphenoidal resection of the pituitary adenoma following pituitary multidisciplinary team discussion. If surgery is contraindicated or declined, pituitary radiotherapy and medical treatment with somatostatin analogs can be used to suppress TSH secretion in 80% of TSHomas [7][8][9][10][11][12].…”

Section: Tsh-secreting Pituitary Adenomamentioning

confidence: 99%

See 3 more Smart Citations

Hyperthyroxinemia with a non-suppressed TSH: how to confidently reach a diagnosis in this clinical conundrum

Timmons

Mukhopadhyay

2020

Hormones

View full text Add to dashboard Cite

Disorders of thyroid function are among the commonest referrals to endocrinology. While interpretation of thyroid function testing is usually straightforward, accurate interpretation becomes significantly more challenging when the parameters do not behave as would be expected in normal negative feedback. In such cases, uncertainty regarding further investigation and management arises. An important abnormal pattern encountered in clinical practice is that of high normal or raised free thyroxine (fT4) with inappropriately non-suppressed or elevated thyroid-stimulating hormone (TSH). In this short review using two clinical vignettes, we examine the diagnostic approach in such cases. A diagnostic algorithm is proposed to ensure that a definitive diagnosis is reached in these challenging cases.

show abstract

Section: Resistance To Thyroid Hormonementioning

confidence: 97%

Section: Tsh-secreting Pituitary Adenomamentioning

confidence: 99%

Section: Tsh-secreting Pituitary Adenomamentioning

confidence: 99%

Section: Tsh-secreting Pituitary Adenomamentioning

confidence: 99%

See 2 more Smart Citations

Hyperthyroxinemia with a non-suppressed TSH: how to confidently reach a diagnosis in this clinical conundrum

Timmons

Mukhopadhyay

2020

Hormones

View full text Add to dashboard Cite

show abstract

“…This study was limited by a small patient sample, so larger studies would be warranted to fully understand the degree of influence imparted onto functional gonadotropic adenomas by GnRHR polymorphisms. TSH-secreting PAs are usually macroadenomas with extrasellar extension [67]. Treatment, as with the previously discussed PAs, revolves around correction of mass effect via surgical resection and amelioration of residual tumor and/or hormonal imbalances [68].…”

Section: Snps In Other Hormone-secreting Pasmentioning

confidence: 99%

The Role of Single-Nucleotide Polymorphisms in Pituitary Adenomas Tumorigenesis

Shah

Aghi

2019

Cancers

View full text Add to dashboard Cite

Pituitary adenomas (PAs) are among the most common intracranial neoplasms, but despite their histologically benign nature, these tumors sometimes grow large enough to cause symptoms of mass effect such as vision loss, headaches, or hypopituitarism. When they get this large, surgery will unfortunately not be curative and, other than prolactinomas, medical options are limited, and radiation has variable efficacy in controlling growth. Understanding the genetic perturbations, such as single nucleotide polymorphisms (SNPs), that promote the formation or growth of functional and nonfunctional PAs is important because such genetic insights could improve the diagnosis and subsequent classification of PAs as well as unlock potential therapeutic targets outside contemporary standard of care. While there have been great strides in the research of SNPs as drivers of PA formation and maintenance, a comprehensive discussion of these genetic mutations has not been undertaken. In the present article, and with the goal of providing scientists and clinicians a central review, we sought to summarize the current literature on SNPs and their relationship to PA formation. Across multiple tumor types, such as nonfunctioning PAs, prolactinomas, corticotroph adenomas, somatotroph adenomas, thyrotropic adenomas, and gonadotroph adenomas, SNPs in cell surface receptors implicated in proliferation can be appreciated. Polymorphisms found in tumor suppressors and cell cycle regulators have also been identified, such as p53 SNPs in nonfunctioning PAs or cyclin D1 in prolactinomas. While the translational relevance of SNPs in the formation of PAs is still in the early stages, the use of wide-scale genomic analysis to identify patients at risk for developing PAs could yield therapeutic benefit in the future.

show abstract

Neoplasms of the Endocrine Glands and Pituitary Neoplasms

Feng¹,

Gandhi²,

Pain³

et al. 2022

Holland‐Frei Cancer Medicine

View full text Add to dashboard Cite

Overview Pituitary neoplasms represent a phenotypically and pathologically diverse family of tumors. Symptoms may derive from abnormal hormone production, compression of adjacent nervous system structures, and in rare cases, metastases. New cell lineage classification based on transcription factors brings new insights into pathogenesis and treatment. Transsphenoidal surgery represents a command well‐tolerated treatment for most pituitary adenomas; however, advances in radiation and chemotherapy have increased treatment options enhancing treatment efficacy and eligibility.

show abstract

Thyrotropin-secreting pituitary adenomas: a systematic review and meta-analysis of postoperative outcomes and management

Cited by 45 publications

References 60 publications

Hyperthyroxinemia with a non-suppressed TSH: how to confidently reach a diagnosis in this clinical conundrum

Hyperthyroxinemia with a non-suppressed TSH: how to confidently reach a diagnosis in this clinical conundrum

The Role of Single-Nucleotide Polymorphisms in Pituitary Adenomas Tumorigenesis

Neoplasms of the Endocrine Glands and Pituitary Neoplasms

Contact Info

Product

Resources

About