TSH-secreting pituitary adenomas: follow-up of 11 cases and review of the literature

Ness-Abramof, R.; Ishay, Avraham; Harel, Gideon; Sylvetzky, Noa; E, Baron; Greenman, Yona; Shimon, Ilan

doi:10.1007/s11102-007-0020-3

Cited by 45 publications

(14 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…And this adenoma was not fibrous but soft enough to remove with suction and gentle curettage unlike a report by Sanno et al [11]. On the other hand, intrasphenoidal adenomectomy caused profuse epidural/ dural hemorrhaging, which is compatible with previous suggestions: The majority of TSHomas are macroadenomas and invasive [1,12]. Our speculation is that cellulose, microfibrillar collagen hemostat, and so on to control bleeding during adenomectomy.…”

Section: Discussionsupporting

confidence: 85%

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

et al. 2010

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 85%

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

et al. 2010

View full text Add to dashboard Cite

show abstract

“…1,2,5,7 Their diagnosis and management are often difficult and challenging. [2][3][4][5][6]11,13 Our study demonstrates that multimodality treatment of TSH-omas results in long-term clinical remission in virtually all patients. Furthermore, the rates of apparent surgical cure are low, the tumours seem refractory to irradiation, and the majority of the patients are still in need of medical therapy during long-term follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…Decrease in tumour mass was reported in approximately 40% of the cases. 2,5,7,10 Nevertheless, due to the low prevalence, there are relatively few studies that describe a series of patients with thyrotrophinomas, 3,4,6,7,[11][12][13][14] and the place of SSA treatment in the management of TSH-omas still remains to be fully established.…”

Section: Introductionmentioning

confidence: 99%

A long‐term follow‐up study of eighteen patients with thyrotrophin‐secreting pituitary adenomas

Varsseveld

Bisschop

Biermasz

et al. 2013

Clinical Endocrinology

View full text Add to dashboard Cite

Our results demonstrate that patients with TSH-omas, who often present with large macroadenomas with extrasellar extension, have an excellent response to SSA therapy. Because the results of surgery and radiotherapy are disappointing, primary medical therapy may be considered in virtually all patients, except in case of optic chiasm compression, especially in those harbouring large adenomas with parasellar extension.

show abstract

“…[7][8][9][10] If surgery is contraindicated or if it fails to cure, the European Thyroid Association guidelines strongly recommend treatment with somatostatin analogs (SSA), such as octreotide and lanreotide, which have proved to be highly effective in a series of studies. [9][10][11][12][13][14][15][16][17][18][19] However, there are cases where manifestation of adverse effects, resistance to or escape from the inhibitory effect of SSAs lead to failure of treatment. 15,18,19 In these cases stereotactic irradiation can be employed.…”

Section: Introductionmentioning

confidence: 99%

TSH-secreting pituitary adenomas treated by gamma knife radiosurgery: our case experience and a review of the literature

Mouslech

Somali

Sakali

et al. 2015

View full text Add to dashboard Cite

A 43-year-old woman, previously misdiagnosed as having primary hyperthyroidism and treated with antithyroid drugs, presented to us with overt hyperthyroidism, high levels of thyroid hormones and elevated thyroid-stimulating hormone (TSH). Μagnetic resonance imaging (MRI) revealed a pituitary microadenoma extending suprasellarly. the patient responded favorably to initial treatment with somatostatin analogs for 2 years but due to the escape phenomenon, tsH levels escalated and hyperthyroidism relapsed. transsphenoidal adenomectomy was applied but recurrence was again observed due to incomplete tumor removal. Gamma knife radiosurgery was finally employed 5.5 years ago, resulting in complete disease remission without evidence of long-term complications to date. thyrotropin-secreting adenomas (tsHomas) are rare with an estimated prevalence of about one case per million. we retrieved from the literature 14 cases of tsHomas treated by gamma knife radiosurgery and compared the outcomes. our results demonstrate the efficacy and safety of gamma knife radiosurgery for achieving remission in most of the cases, suggesting validation of this technique as an effective treatment option for the management of recurrent tsHomas.

show abstract

TSH-secreting pituitary adenomas: follow-up of 11 cases and review of the literature

Cited by 45 publications

References 21 publications

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

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

A long‐term follow‐up study of eighteen patients with thyrotrophin‐secreting pituitary adenomas

TSH-secreting pituitary adenomas treated by gamma knife radiosurgery: our case experience and a review of the literature

Contact Info

Product

Resources

About