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Ectopic Suprasellar Thyrotropin-Secreting Pituitary Adenoma: Case Report and Literature Review.
World Neurosurg. 2016 Nov; 95:617.e13-617.e18.WN

Abstract

BACKGROUND

Ectopic thyroid-stimulating hormone (TSH)-secreting pituitary adenomas are rare and can often be misdiagnosed as primary hyperthyroidism. We present a case of an ectopic suprasellar TSH-secreting pituitary adenoma. A literature review of previously reported ectopic TSH-secreting and suprasellar pituitary adenomas is included to illustrate the clinical characteristics of this disease entity and the diversity of operative approaches to treating ectopic suprasellar pituitary adenomas.

CASE DESCRIPTION

A 46-year-old man presented with typical clinical signs of hyperthyroidism and a history of progressive visual field impairment and vision loss. Laboratory investigations revealed that the patient had elevated levels of free thyroxine and free triiodothyronine and a normal level of TSH. Neuro-ophthalmologic examination showed right eye/left eye = 1.0/0.6 and left temporal hemianopia. Magnetic resonance imaging revealed a mass located in the suprasellar space. The patient underwent preoperative short-term octreotide treatment followed by gross total resection of the tumor via the extended endoscopic endonasal transtuberculum sellar approach. At 6-month follow-up evaluation, the patient's endocrinologic function tests met the criteria for cure, and magnetic resonance imaging revealed a normal pituitary gland and stalk with no tumor recurrence. Histologic diagnosis confirmed the presence of a TSH-secreting pituitary adenoma.

CONCLUSIONS

To the best of our knowledge, this is the first reported case of an ectopic suprasellar TSH-secreting pituitary adenoma. Preoperative preparation and complete resection are the keys to a cure. The extended endoscopic endonasal transtuberculum sellar approach is an alternative minimally invasive method for the removal of an ectopic suprasellar pituitary adenoma.

Authors+Show Affiliations

Department of Neurosurgery, Neuroscience Center, Wuxi Second Hospital Affiliated with Nanjing Medical University, Wu'xi, Jiangsu Province, China.Department of Neurosurgery, Neuroscience Center, Wuxi Second Hospital Affiliated with Nanjing Medical University, Wu'xi, Jiangsu Province, China. Electronic address: xiaojie-lu@hotmail.com.Department of Neurosurgery, Neuroscience Center, Wuxi Second Hospital Affiliated with Nanjing Medical University, Wu'xi, Jiangsu Province, China.Department of Neurosurgery, Neuroscience Center, Wuxi Second Hospital Affiliated with Nanjing Medical University, Wu'xi, Jiangsu Province, China.Department of Endocrinology, Wuxi Second Hospital Affiliated with Nanjing Medical University, Wu'xi, Jiangsu Province, China.Department of Ophthalmology, Wuxi Second Hospital Affiliated with Nanjing Medical University, Wu'xi, Jiangsu Province, China.

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

27567574

Citation

Wang, Qing, et al. "Ectopic Suprasellar Thyrotropin-Secreting Pituitary Adenoma: Case Report and Literature Review." World Neurosurgery, vol. 95, 2016, pp. 617.e13-617.e18.
Wang Q, Lu XJ, Sun J, et al. Ectopic Suprasellar Thyrotropin-Secreting Pituitary Adenoma: Case Report and Literature Review. World Neurosurg. 2016;95:617.e13-617.e18.
Wang, Q., Lu, X. J., Sun, J., Wang, J., Huang, C. Y., & Wu, Z. F. (2016). Ectopic Suprasellar Thyrotropin-Secreting Pituitary Adenoma: Case Report and Literature Review. World Neurosurgery, 95, e13-e18. https://doi.org/10.1016/j.wneu.2016.08.062
Wang Q, et al. Ectopic Suprasellar Thyrotropin-Secreting Pituitary Adenoma: Case Report and Literature Review. World Neurosurg. 2016;95:617.e13-617.e18. PubMed PMID: 27567574.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ectopic Suprasellar Thyrotropin-Secreting Pituitary Adenoma: Case Report and Literature Review. AU - Wang,Qing, AU - Lu,Xiao-Jie, AU - Sun,Jun, AU - Wang,Jing, AU - Huang,Ci You, AU - Wu,Zhi Feng, Y1 - 2016/08/25/ PY - 2016/06/23/received PY - 2016/08/12/revised PY - 2016/08/13/accepted PY - 2016/8/29/pubmed PY - 2017/10/3/medline PY - 2016/8/29/entrez KW - Ectopic KW - Endoscope KW - Pituitary adenoma KW - Suprasellar KW - Thyrotropin SP - 617.e13 EP - 617.e18 JF - World neurosurgery JO - World Neurosurg VL - 95 N2 - BACKGROUND: Ectopic thyroid-stimulating hormone (TSH)-secreting pituitary adenomas are rare and can often be misdiagnosed as primary hyperthyroidism. We present a case of an ectopic suprasellar TSH-secreting pituitary adenoma. A literature review of previously reported ectopic TSH-secreting and suprasellar pituitary adenomas is included to illustrate the clinical characteristics of this disease entity and the diversity of operative approaches to treating ectopic suprasellar pituitary adenomas. CASE DESCRIPTION: A 46-year-old man presented with typical clinical signs of hyperthyroidism and a history of progressive visual field impairment and vision loss. Laboratory investigations revealed that the patient had elevated levels of free thyroxine and free triiodothyronine and a normal level of TSH. Neuro-ophthalmologic examination showed right eye/left eye = 1.0/0.6 and left temporal hemianopia. Magnetic resonance imaging revealed a mass located in the suprasellar space. The patient underwent preoperative short-term octreotide treatment followed by gross total resection of the tumor via the extended endoscopic endonasal transtuberculum sellar approach. At 6-month follow-up evaluation, the patient's endocrinologic function tests met the criteria for cure, and magnetic resonance imaging revealed a normal pituitary gland and stalk with no tumor recurrence. Histologic diagnosis confirmed the presence of a TSH-secreting pituitary adenoma. CONCLUSIONS: To the best of our knowledge, this is the first reported case of an ectopic suprasellar TSH-secreting pituitary adenoma. Preoperative preparation and complete resection are the keys to a cure. The extended endoscopic endonasal transtuberculum sellar approach is an alternative minimally invasive method for the removal of an ectopic suprasellar pituitary adenoma. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/27567574/Ectopic_Suprasellar_Thyrotropin_Secreting_Pituitary_Adenoma:_Case_Report_and_Literature_Review_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(16)30730-6 DB - PRIME DP - Unbound Medicine ER -