The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Clinical Characteristics and Treatments of Patients with TSH Secreting Pituitary Adenoma

TSH 분비 뇌하수체 선종 환자들의 임상적, 생화학적 특징과 치료

  • Kim, Dong-Sun (Department of Internal Medicine, Hanyang University College of Medicine)
  • 김동선 (한양대학교 의과대학 내과학교실)
  • Published : 2011.01.01
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Abstract

TSH secreting pituitary adenoma is a very rare disease, but it should be carefully suspected in patients with the lack of inhibition of TSH levels in the presence of increased thyroid hormones. The clinical manifestations are similar to those of hyperthyroidism, so TSH secreting pituitary adenoma can be easily misdiagnosed as hyperthyroidism resulting in inappropriate treatment. Surgery is the treatment of choice and the long-acting somatostatin analogs are effective in reducing TSH secretion with consequent restoration of the euthyroid state in the majority. Recently, development of neuroradiological techniques and better recognition of TSH-secreting adenomas increase the rate of diagnosis as microadenoma and improve surgical cure rate in patients with TSH secreting pituitary adenoma.

Keywords

References

  1. 이우경, 황세나, 임정수, et al. TSH 분비 뇌하수체 선종 환자들의 임상적, 생화학적 특징과 치료. 대한내과학회지 2010;80:47-55
  2. Socin HV, Chanson P, Delemer B, et al. The changing spectrum of TSH-secreting pituitary adenomas: diagnosis and management in 43 patients. Eur J Endocrinol 2003;148:433-442. https://doi.org/10.1530/eje.0.1480433
  3. Beck-Peccoz P, Brucker-Davis F, Persani L, et al. Thyrotropin-secreting pituitary tumors. Endoc Rev 1996;17:610-638.
  4. Ness-Abramof R, Ishay A, Harel G, et al. TSH-secreting pituitary adenomas: follow-up of 11 cases and review of the literature. Pituitary 2007;10:307-310. https://doi.org/10.1007/s11102-007-0020-3
  5. Mantovani G, Asteria C, Pellegrini C, et al. HESX1 expression in human normal pituitaries and pituitary adenomas. Mol Cell Endocrinol 2006;247:135-139. https://doi.org/10.1016/j.mce.2005.12.036
  6. Agrawal NK, Goyal R, Rastogi A, Naik D, Singh SK. Thyroid hormone resistance. Postgrad Med J. 2008;84:473-477. https://doi.org/10.1136/pgmj.2008.069740
  7. Losa M, Mortini P, Minelli R, et al. Coexistence of TSH-secreting pituitary adenoma and autoimmune hypothyroidism. Journal of Endocrinological Investigation 2006;29:555-559. https://doi.org/10.1007/BF03344147
  8. Persani L, Preziati D, Matthews CH, et al. Serum levels of carboxyterminal cross-linked telopeptide of type I collagen (ICTP) in the differential diagnosis of the syndromes of inappropriate secretion of TSH. Clinical Endocrinol 1997;47:207-214. https://doi.org/10.1046/j.1365-2265.1997.2351057.x
  9. Asteria C, Anagni M, Persani L, Beck Peccoz P. Loss of heterozygosity of the MEN1 gene in a large series of TSH-secreting pituitary adenomas. J Endocrinol Invest 2001;24:796-801. https://doi.org/10.1007/BF03343929
  10. Horiguchi K, Yamada M, Umezawa R, et al. Somatostatin receptor subtypes mRNA in TSH-secreting pituitary adenomas: a case showing a dramatic reduction in tumor size during short octreotide treatment. Endocr J 2007;54:371-378. https://doi.org/10.1507/endocrj.K06-177
  11. Kuhn JM, Arlot S, Lefebvre H, et al. Evaluation of the treatment of thyrotropin-secreting pituitary adenomas with a slow release formulation of the somatostatin analog lanreotide. J Clin Endocrinol Metab 2000;85:1487-1491. https://doi.org/10.1210/jc.85.4.1487