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Thyrotropin-secreting pituitary adenomas: report of seven cases.
J Clin Endocrinol Metab. 1991 Feb; 72(2):477-83.JC

Abstract

Seven patients with hyperthyroidism due to a TSH-secreting pituitary macroadenoma have been observed of a total of 800 patients with pituitary tumors over a period of 15 yr. Serum TSH levels varied between 1.1-36.3 mU/L. The serum alpha-subunit level was low in 1 case, while in 4 other cases the concentration was elevated and varied between 3.7-7.8 micrograms/L. Serum TSH beta levels were normal in the 4 cases in which it was determined. Serum GH or PRL levels were elevated in 5 cases. In 1 patient the cosecretion of TSH, GH, and PRL was confirmed by immunocytochemical examination. Serum TSH and alpha-subunit responses to TRH, GnRH, CRF, GRF, dexamethasone, methimazole, T3, and bromocriptine administration were variable when studied. Serum TSH and alpha-subunit circadian rhythms were absent in 1 case and inverted in another. A serum alpha-subunit pulsatility without TSH pulses was observed in 1 patient. Five patients underwent transsphenoidal adenomectomy. Three of 4 patients operated on in our center were cured, but a recurrence of the adenoma was found in 1 of them after 5 yr. The fifth patient was not cured. Treatment with octreotide in 3 patients resulted in normalization of serum TSH, GH, and thyroid hormones levels. Cosecretion of PRL in 1 case and alpha-subunit in 2 cases was also inhibited. Partial tachyphylaxis occurred in 1 patient. In summary, heterogeneity in clinical presentation, hormonal expression, and therapeutic response appears to characterize these TSH-secreting adenomas.

Authors+Show Affiliations

Department of Endocrinology, University of Liège, Belgium.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

1704011

Citation

Beckers, A, et al. "Thyrotropin-secreting Pituitary Adenomas: Report of Seven Cases." The Journal of Clinical Endocrinology and Metabolism, vol. 72, no. 2, 1991, pp. 477-83.
Beckers A, Abs R, Mahler C, et al. Thyrotropin-secreting pituitary adenomas: report of seven cases. J Clin Endocrinol Metab. 1991;72(2):477-83.
Beckers, A., Abs, R., Mahler, C., Vandalem, J. L., Pirens, G., Hennen, G., & Stevenaert, A. (1991). Thyrotropin-secreting pituitary adenomas: report of seven cases. The Journal of Clinical Endocrinology and Metabolism, 72(2), 477-83.
Beckers A, et al. Thyrotropin-secreting Pituitary Adenomas: Report of Seven Cases. J Clin Endocrinol Metab. 1991;72(2):477-83. PubMed PMID: 1704011.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Thyrotropin-secreting pituitary adenomas: report of seven cases. AU - Beckers,A, AU - Abs,R, AU - Mahler,C, AU - Vandalem,J L, AU - Pirens,G, AU - Hennen,G, AU - Stevenaert,A, PY - 1991/2/1/pubmed PY - 1991/2/1/medline PY - 1991/2/1/entrez SP - 477 EP - 83 JF - The Journal of clinical endocrinology and metabolism JO - J Clin Endocrinol Metab VL - 72 IS - 2 N2 - Seven patients with hyperthyroidism due to a TSH-secreting pituitary macroadenoma have been observed of a total of 800 patients with pituitary tumors over a period of 15 yr. Serum TSH levels varied between 1.1-36.3 mU/L. The serum alpha-subunit level was low in 1 case, while in 4 other cases the concentration was elevated and varied between 3.7-7.8 micrograms/L. Serum TSH beta levels were normal in the 4 cases in which it was determined. Serum GH or PRL levels were elevated in 5 cases. In 1 patient the cosecretion of TSH, GH, and PRL was confirmed by immunocytochemical examination. Serum TSH and alpha-subunit responses to TRH, GnRH, CRF, GRF, dexamethasone, methimazole, T3, and bromocriptine administration were variable when studied. Serum TSH and alpha-subunit circadian rhythms were absent in 1 case and inverted in another. A serum alpha-subunit pulsatility without TSH pulses was observed in 1 patient. Five patients underwent transsphenoidal adenomectomy. Three of 4 patients operated on in our center were cured, but a recurrence of the adenoma was found in 1 of them after 5 yr. The fifth patient was not cured. Treatment with octreotide in 3 patients resulted in normalization of serum TSH, GH, and thyroid hormones levels. Cosecretion of PRL in 1 case and alpha-subunit in 2 cases was also inhibited. Partial tachyphylaxis occurred in 1 patient. In summary, heterogeneity in clinical presentation, hormonal expression, and therapeutic response appears to characterize these TSH-secreting adenomas. SN - 0021-972X UR - https://www.unboundmedicine.com/medline/citation/1704011/Thyrotropin_secreting_pituitary_adenomas:_report_of_seven_cases_ L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jcem-72-2-477 DB - PRIME DP - Unbound Medicine ER -