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[Two cases of TSH-secreting pituitary adenoma; endocrinological, diagnostic and therapeutic approach to the disease].
No Shinkei Geka. 1991 Sep; 19(9):883-9.NS

Abstract

Two cases of TSH-secreting pituitary adenoma were reported. Endocrinological and immunohistochemical features of these cases were described and problems in diagnosis and treatment of the rare disease are discussed. [case 1] A 28 year-old woman suffered from hyperthyroidism with a relatively high value of serum TSH (T3; 350 ng/dl, T4; 10.0 micrograms/dl, TSH; 24.5 microU/ml). She was treated with antithyroid drug and then underwent subtotal thyroidectomy. Although the levels of serum T3 and T4 were lowered to within normal range, the level of serum TSH still remained high. One month later, she developed frontal headache, amenorrhea and bitemporal hemianopsia. A CT scan showed an enhanced mass in the sellar and suprasellar region. Preoperative endocrinological studies showed elevated values of TSH (47 microU/ml) and its alpha-subunit (9.0 ng/ml). The levels of both T3 (190 ng/dl) and T4 (10.0 micrograms/dl) were near the upper normal limit. Serum TSH was suppressed by administration of exogenous T3, but did not respond to exogenous TRH, l-Dopa nor bromocriptine. Under the diagnosis of TSH-secreting pituitary adenoma, the patient was operated on by craniotomy and received local radiation therapy (50 Gy). In 1990, 12 years after the treatment, she is well and endocrinologically normal. Immunohistochemical study revealed that most tumor cells were positive for TSH. [case 2] A 28 year-old woman visited our hospital for examination of hyperthyroidism. Serum level of TSH was detectable (4.5 microU/ml). A CT scan performed at that time disclosed no pituitary tumor. Thyroid function was normalized by antithyroid drug, but the level of TSH was still high and progressively increased.(ABSTRACT TRUNCATED AT 250 WORDS)

Authors+Show Affiliations

Department of Neurosurgery, Setsunan General Hospital.No affiliation info availableNo affiliation info availableNo 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

jpn

PubMed ID

1944800

Citation

Higuchi, M, et al. "[Two Cases of TSH-secreting Pituitary Adenoma; Endocrinological, Diagnostic and Therapeutic Approach to the Disease]." No Shinkei Geka. Neurological Surgery, vol. 19, no. 9, 1991, pp. 883-9.
Higuchi M, Mori S, Arita N, et al. [Two cases of TSH-secreting pituitary adenoma; endocrinological, diagnostic and therapeutic approach to the disease]. No Shinkei Geka. 1991;19(9):883-9.
Higuchi, M., Mori, S., Arita, N., Ohnishi, T., Hayakawa, T., Miyai, K., Mori, H., Azukisawa, M., & Maeda, Y. (1991). [Two cases of TSH-secreting pituitary adenoma; endocrinological, diagnostic and therapeutic approach to the disease]. No Shinkei Geka. Neurological Surgery, 19(9), 883-9.
Higuchi M, et al. [Two Cases of TSH-secreting Pituitary Adenoma; Endocrinological, Diagnostic and Therapeutic Approach to the Disease]. No Shinkei Geka. 1991;19(9):883-9. PubMed PMID: 1944800.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Two cases of TSH-secreting pituitary adenoma; endocrinological, diagnostic and therapeutic approach to the disease]. AU - Higuchi,M, AU - Mori,S, AU - Arita,N, AU - Ohnishi,T, AU - Hayakawa,T, AU - Miyai,K, AU - Mori,H, AU - Azukisawa,M, AU - Maeda,Y, PY - 1991/9/1/pubmed PY - 1991/9/1/medline PY - 1991/9/1/entrez SP - 883 EP - 9 JF - No shinkei geka. Neurological surgery JO - No Shinkei Geka VL - 19 IS - 9 N2 - Two cases of TSH-secreting pituitary adenoma were reported. Endocrinological and immunohistochemical features of these cases were described and problems in diagnosis and treatment of the rare disease are discussed. [case 1] A 28 year-old woman suffered from hyperthyroidism with a relatively high value of serum TSH (T3; 350 ng/dl, T4; 10.0 micrograms/dl, TSH; 24.5 microU/ml). She was treated with antithyroid drug and then underwent subtotal thyroidectomy. Although the levels of serum T3 and T4 were lowered to within normal range, the level of serum TSH still remained high. One month later, she developed frontal headache, amenorrhea and bitemporal hemianopsia. A CT scan showed an enhanced mass in the sellar and suprasellar region. Preoperative endocrinological studies showed elevated values of TSH (47 microU/ml) and its alpha-subunit (9.0 ng/ml). The levels of both T3 (190 ng/dl) and T4 (10.0 micrograms/dl) were near the upper normal limit. Serum TSH was suppressed by administration of exogenous T3, but did not respond to exogenous TRH, l-Dopa nor bromocriptine. Under the diagnosis of TSH-secreting pituitary adenoma, the patient was operated on by craniotomy and received local radiation therapy (50 Gy). In 1990, 12 years after the treatment, she is well and endocrinologically normal. Immunohistochemical study revealed that most tumor cells were positive for TSH. [case 2] A 28 year-old woman visited our hospital for examination of hyperthyroidism. Serum level of TSH was detectable (4.5 microU/ml). A CT scan performed at that time disclosed no pituitary tumor. Thyroid function was normalized by antithyroid drug, but the level of TSH was still high and progressively increased.(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0301-2603 UR - https://www.unboundmedicine.com/medline/citation/1944800/[Two_cases_of_TSH_secreting_pituitary_adenoma L2 - https://medlineplus.gov/pituitarytumors.html DB - PRIME DP - Unbound Medicine ER -