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TSH secreting adenomas


Authors: Jana Ježková;  Josef Marek
Authors‘ workplace: III. interní klinika 1. LF UK a VFN v Praze
Published in: Vnitř Lék 2016; 62(Suppl 3): 77-81
Category: Reviews

Overview

Adenomas which secrete thyrotropic hormone (thyrotropinomas) are rare and constitute less than 3 % of pituitary adenomas. In laboratory studies there is a typical elevation of thyroid hormones with nonsupressible TSH. In differential diagnostics it is necessary to distinguish above all the syndrome of resistance to thyroid hormones. Clinical symptoms are usually mild and correspond to symptoms of hyperthyroidism. Goiter is a common finding. In 80 % of cases thyrotropinomas are diagnosed in a stage of invasively growing macroadenoma. The primary treatment is neurosurgical removal adenoma which results in cure in 40 % of patients. Other treatment options include radiation therapy and medical treatment (treatment with somatostatin analogues). With regard to the risk of adenoma recurrence, the long-term follow–up is similar to that of cases of other pituitary adenomas necessary.

Key words:
resistance to thyroid hormone – TSH secreting adenoma – thyreotropin


Sources

1. Davis JRE, Farrel WE, Clayton RN. Pituitary tumors. Reproduction 2001; 121(3): 363–371.

2. Raappana A, Koivukangas J, Ebeling T et al. Incidence of pituitary adenomas in Northern Finland in 1992–2007. J Clin Endocrinol Metab 2010; 95(9): 4268–4275. Dostupné z DOI: <http://dx.doi.org/10.1210/jc.2010–0537>.

3. Önnestam L, Berinder K, Burman P et al. National incidence and prevalence of TSH-secreting pituitary adenomas in Sweden. J Clin Endocrinol Metab 2013; 98(2): 626–635. Dostupné z DOI: <http://dx.doi.org/10.1210/jc.2012–3362>.

4. Saeger W, Lüdecke DK, Buchfelder M et al. Pathohistological classification of pituitary tumors: 10 years of experience with the German Pituitary Tumor Register. Eur J Endocrinol 2007; 156(2): 203–216.

5. Jailer JW, Holub DA. Remission of Graves´ disease following radiotherapy of a pituitary neoplasm. Am J Med 1960; 28: 497–500.

6. Kovacs K, Horvath E. Tumors of the pituitary gland. In: Harthmann WH, Sobin LH. Atlas of Tumor Pathology, fascicle 21, series 2. Armed Forced Institute of Pathology: Washington, DC 1986.

7. Thotakura NR, LiCalzi L, Weintraub BD. The role of carbohydrate in thyrotropin action assessed by a novel method of enzymatic deglycosylation. J Biol Chem 1990; 265(20): 11527–11534.

8. Friedmann JM, Halaas JL. Leptin and the regulation of body weight in mammals. Nature 1998; 395(6704): 763–770.

9. Urman S, Critchlow V. Long-term elevations in plasma thyrotropin, but not growth hormone, concentrations associated with lesion –induced depletion of median eminence somatostatin. Endocrinology 1983; 112(2): 659–664.

10. Foord SM, Peters JR, Dieguez C et al. Dopamine receptors on intact anterior pituitary cells in culture: Functional association with the inhibition of prolactin and thyrotropin. Endocrinology 1983; 112(5): 1567–1577.

11. Fekete C, Kelly J, Mihaly E et al. Neuropeptide Y has a central inhibitory action on the hypothalamic- pituitary-thyroid axis. Endocrinology 2001; 142(6): 2606–2613.

12. Roelsfema F, Pereira AM, Biermasz NR et al. Diminished and irregular TSH secretion with delayed acrophase in patients with Cushing´s syndrome. Eur J Endocrinol 2009; 161(5): 695–703. Dostupné z DOI: <http://dx.doi.org/10.1530/EJE-09–0580>.

13. Hermus RM, Sweep CG, van der Meer MJ et al. Continuous infusion of interleukin-1 induces a non-thyroidal illness syndrome in the rat. Endocrinology 1992; 131(5): 2139- 2146.

14. Van der Poll T, Romijn JA, Wiersinga WM et al. Tumor necrosis factor: A putative mediator of the sick euthyroid syndrome in man. J Clin Endocrinol Metab 1990; 71(6): 1567–1572.

15. Torpy DJ, Tsigos C, Lotsikas AJ et al. Acute and delayed effects of a single-dose injection of interleukin-6 on thyroid function in healthy humus. Metabolism 1998; 47(10): 1289–1293.

16. Banerjee AK, Sharma BS, Kak VK. Clinically and biochemically silent thyrotroph adenoma with oncocytic change. Neurol India 2000; 48(4): 374–377.

17. Ma W, Ikeda H, Watabe N et al. A plurihomonal TSH –producing pituitary tumor of monoclonal origin in a patient with hypothyroidism. Horm Res 2003; 59(5): 257–261.

18. Taylor TJ, Donlon SS, Bale AE et al. Treatment of a thyrotropinoma with octreotide – LAR in patient with multiple endocrine neoplasia 1. Thyroid 2000; 10(11): 1001–1007.

19. Gessl A, Freissmuth M, Czech T et al. Growth hormone-prolactin-thyrotropin-secreting pituitary adenoma in atypical McCune-Albright syndrome with functionally normal Gs alpha protein. J Clin Endocrinol Metab 1994; 79(4): 1128–1134.

20. Tichomirowa MA, Daly AF, Beckers A. Familiar pituitary adenomas. J Intern Med 2009; 266(1): 5–18. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1365–2796.2009.02109.x>.

21. Ezzat S, Horvath E, Kovacs K et al. Basic fibroblast growth factor expression in two prolactin and thyrotropin-producing pituitary adenomas. Endocr Pathol 1995; 6(2): 125–134.

22. Mixson AJ, Friedman TC, Katz DA et al. Thyrotropin-secreting pituitary carcinoma. J Clin Endocrinol Metab 1993; 76(2): 529–533.

23. Brown RL, Muzzafar T, Wollman R et al. A pituitary carcinoma secreting TSH and prolactin: A non-secreting adenom agone awry. Eur J Endocrinol 2006; 154(5): 639–643.

24. Lee W, Cheung AS, Freilich R. TSH-secreting pituitary carcinoma with intrathecal drop metastase. Clin Endocrinol 2012; 76(4): 604–606. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1365–2265.2011.04288.x>.

25. 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(4): 433–442.

26. George JT, Thow JC, Matthews B et al. Atrial fibrillation associated with a thyroid stimulating hormone-secreting adenoma of the pituitary gland leading to a presentation of acute cardiac decompensation: a case report. J Med Case Rep 2008; 28: 67. Dostupné z DOI: <http://dx.doi.org/10.1186/1752–1947–2-67>.

27. Yovos JG, Falko JM, O´Dorisio TM et al. Thyrotoxicosis and a thyrotroping-sereting pituitary tumor causing unilateral exophtalmos. J Clin Endocrinol Metab 1981; 53(2): 338–343.

28. Poggi M, Monti S, Pascucci C et al. A rare case of follicular thyroid carcinoma in a patient with thyrotropin-secreting pituitary adenoma. Am J Med Sci 2009; 337(6): 462–465. Dostupné z DOI: <http://dx.doi.org/10.1097/MAJ.0b013e3181949948>.

29. Perticone F, Pigliaru F, Marriotti S et al. Is the incidence of differentiated thyroid cancer increased in patients with thyrotropin-secreting adenomas? Thyroid 2015; 25(4): 417–424. Dostupné z DOI: <http://dx.doi.org/10.1089/thy.2014.0222>.

30. Kuhn JM, Arlot S, Lefebvre H et al. Evaluation of the treatment of thyroid-secreting pituitary adenomas with a slow release of the somatostatin analog lanreotide. J Clin Endocrinol Metab 2000; 85(4): 1487–1491.

31. Beck-Peccoz P, Persani L. Variable biological activity of thyroid-stmulating hormone. Eur J Endocrinol 1994; 131(4): 331–340.

32. Magner JA, Klibanski A, Fein H et al. Ricin and lentil lectin affinity chromatografy reveals oligosaccharide heterogenity of thyrotropin secreted by 12 human pituitary tumors. Metabolism 1992; 41(9): 1009–1015.

33. Losa M, Giovanelli M, Persani L et al. Criteria of cure and follow-up of central hyperthyroidism due to thyrotropin-secreting pituitary adenomas. J Clin Endocrinol Metab 1996; 81(8): 3084–3090.

34. Brucker-Davis F, Oldfield EH, Skarulis MC et al. Thyrotropin-secreting pituitary tumors: Diagnosis criteria, thyroid hormone sensitivity, and treatment outcome in 25 patients followed at the National Institutes of Health. J Clin Endocrinol Metab1999; 84(2): 476–486.

35. Beck-Peccoz P, Roncoroni R, Mariotti S et al. Sex hormone-binding globulin measurement in patients with inappropriate secretion of thyrotropin (IST): evidence against selective pituitary thyroid hormone resistance in nonneoplastic IST. J Clin Endocrinol Metab 1990; 71(1): 19–25.

36. Beck-Peccoz P, Persani L. TSH-producing adenomas. In: Jameson JL, DeGroot LJ (eds). Endocrinology. 5th ed. Saunders USA: 2006: 324–332. ISBN 9780721603766.

37. Beck-Peccoz P, Persani L, Mannavola D et al. Pituitary tumours: TSH-secretin adenomas. Best Pract Res Clin Endocrinol Metab 2009; 23(5): 597–606. Dostupné z DOI: <http://dx.doi.org/10.1016/j.beem.2009.05.006>.

38. Clarke MJ, Erickson D, Castro MR et al. Thyroid-stimulating hormone pituitary adenomas. J Neurosurg 2008; 109(1): 17–22. Dostupné z DOI: <http://dx.doi.org/10.3171/JNS/2008/109/7/0017>.

39. Cooper DS, Wening BM. Hyperthyroidism caused by an ectopic TSH-secreting pituitary tumor. Thyroid 1996; 6(4): 337–343.

40. Glendenning P, Siriwardhana D, Hoad K et al. Thyroxine autoantibody interference is an uncommon cause of inappropriate TSH secretion using the Immulite 2000 assay. Clin Chim Acta 2009; 403(1–2): 136–138. Dostupné z DOI: <http://dx.doi.org/10.1016/j.cca.2009.02.002>.

41. Tan MJ, Tan F, Hawkins R et al. A hyperthyroid patient with measurable thyroid-stimulating hormone concentration – a trap for the unwary. Ann Acad Med Singapore 2006; 35(7): 500–503.

42. Cartwright D, O´Shea P, Rajanayagam O et al. Familiar dysalbuminemic hyperthyroxinemia: A persistent diagnostic challenge. Clin Chem 2009; 55(5): 1044–1046. Dostupné z DOI: <http://dx.doi.org/10.1373/clinchem.2008.120303>.

43. Slezak R, Lukienczuk T, Noczynska A et al. A novel p.E311K mutation of thyroid receptor beta gene in resistence to thyroid hormone syndrome, inherited in autosomal recessive trait. Horm Metab Res 2012; 44(9): 704–707. Dostupné z DOI: <http://dx.doi.org/10.1055/s-0032–1312666>.

44. Dumitrescu AM, Refetoff S. The syndromes of reduced sensitivity to thyroid hormone. Biochim Biophys Acta 2013; 1830(7): 3987–4003. Dostupné z DOI: <http://dx.doi.org/10.1016/j.bbagen.2012.08.005>.

45. Weiss WR, Refetoff S. Resistance to Thyroid Hormone (RTH) (non TR- RTH). Hot Thyroidol 2009; 9: 1–11.

46. Gurnell M, Halsall DJ, Chatterjee VK. What should be done when thyroid function tests do not make sense? Clin Endocrinol 2011; 74(6): 673–678. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1365–2265.2011.04023.x>.

47. Beck-Peccoz P, Brucker-Davis F, Persani L et al. Thyrotropin-secreting pituitary tumors. Endocr Rev 1996; 17(6): 610–638.

48. Yamada S, Fukuhara N, Horiguchi K et al. Clinicopathological characteristics and therapeutic outcomes in thyrotropin-secreting pituitary adenomas: a single-center study of 90 cases. J Neurosurg 2014; 121(6): 1462–1473. Dostupné z DOI: <http://dx.doi.org/10.3171/2014.7.JNS1471>.

49. Kirkman MA, Jaunmutkane Z, Brandner S et al. Active and silent thyroid-stimulating hormone-expressing pituitary adenomas: presenting symptoms, treatment, outcomes, and recurrence. World Neurosurg 2014; 82(6): 1224–1231. Dostupné z DOI: <http://dx.doi.org/10.1016/j.wneu.2014.03.031>.

50. Caron P, Arlot S, Bauters C et al. Efficacy of the long-acting octreotide formulation (octreotide-LAR) in patients with thyrotropin-secreting pituitary adenomas. J Clin Endocrinol Metab 2001; 86(6): 2849–2853.

51. Beck-Peccoz P, Persani L. Medical management of thyrotropin-secreting pituitary adenomas. Pituitary 2002; 5(2): 83–88.

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Diabetology Endocrinology Internal medicine

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