Atypical thyrotropin-secreting pituitary microadenoma revealed by severe osteoporosis in a young man

Rougemont, Alexis de; Mourot, M; Riou, Jean‐Paul

doi:10.1007/s00774-009-0050-1

Cited by 5 publications

(4 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These findings suggest that VFs are an early complication of secondary hyperthyroidism, consistent with a published case report in which severe osteoporosis with multiple VFs was the clinical presentation of TSH-oma [15]. Our study proposes that VFs may develop early in the clinical history of TSH-oma in predisposed patients (more advanced age and possibly menopause, elevated thyroid hormones, no pretreatment with SRLs) as a direct consequence of hyperthyroidism.…”

Section: Discussionsupporting

confidence: 91%

“…Consistently, normalization of bone turnover was observed after treatment of TSH-oma [13]. However, in only one case report, data on fractures were reported [15]. …”

Section: Discussionmentioning

confidence: 64%

“…However, when thyroid hormones increase, bone remodeling is excessively stimulated with consequent bone loss, a decrease in bone mineral density (BMD), and an increase in vertebral and nonvertebral fracture risk [9–12]. Different from primary hyperthyroidism, only very few studies investigated the impact of secondary hyperthyroidism on skeletal end points, with data being limited to the evaluation of biochemical markers of bone turnover [13, 14], whereas the paucity of data on BMD and fracture risk is striking [15]. …”

mentioning

confidence: 99%

See 2 more Smart Citations

High Prevalence of Radiological Vertebral Fractures in Patients With TSH-Secreting Pituitary Adenoma

Frara

Losa

Doga

et al. 2018

Journal of the Endocrine Society

View full text Add to dashboard Cite

BackgroundBone loss and high risk of fractures have been reported in patients with primary hyperthyroidism, whereas data on skeletal health in TSH-secreting adenoma (TSH-oma) are scant, and the risk of fractures in this specific clinical context has not been investigated so far. In this cross-sectional study, we aimed at evaluating for the first time, to our knowledge, the prevalence and determinants of radiological vertebral fractures (VFs) in patients with TSH-oma.MethodsTwenty-two patients (10 males, 12 females; median age 47 years) with TSH-oma and 44 patients (20 males, 24 females; median age 49 years) with nonfunctioning pituitary adenoma (NFPA) were retrospectively evaluated for thoracic VFs using a morphometric approach on lateral chest X-ray routinely performed in the presurgical diagnostic workup.ResultsThe prevalence of VFs was significantly higher in TSH-oma vs NFPA (59.1% vs 22.7%; P = 0.003), the difference being still significant (odds ratio, 10.5; P = 0.005) after correction for the size of pituitary adenomas and biochemical parameters. In TSH-oma, the prevalence of VFs was significantly associated with older age (P = 0.007) and higher serum free T4 values (P = 0.02). In 20 patients, data on presurgical medical therapies of TSH-oma were available. All patients not treated with somatostatin receptor ligands were fractured compared with 25% of those who were treated with these drugs (P = 0.001). No significant (P = 0.25) association between VFs and treatment with methimazole was found.ConclusionsThis study provides the first evidence, to our knowledge, that patients with TSH-oma may develop VFs in close relationship with severity of hyperthyroidism.

show abstract

Section: Discussionsupporting

confidence: 91%

“…Consistently, normalization of bone turnover was observed after treatment of TSH-oma [13]. However, in only one case report, data on fractures were reported [15]. …”

Section: Discussionmentioning

confidence: 64%

mentioning

confidence: 99%

See 1 more Smart Citation

High Prevalence of Radiological Vertebral Fractures in Patients With TSH-Secreting Pituitary Adenoma

Frara

Losa

Doga

et al. 2018

Journal of the Endocrine Society

View full text Add to dashboard Cite

show abstract

“…Thus, TSH can inhibit osteoclast formation and survival by attenuating signals triggered in response to tumor necrosis factor-α (TNF-α). TSH also suppresses osteoblast differentiation and type I collagen expression 11 .…”

Section: Discussionmentioning

confidence: 99%

Mixed Thyrotropin-Secreting Pituitary Adenoma Coexisted with Graves' Disease: a case report

Huang

Wen

Liang

et al. 2023

Preprint

View full text Add to dashboard Cite

Background At present, thyrotropin-secreting pituitary adenoma (TSHoma) is recognized as a rare disease. Mixed TSHomas accounted for 20-25% of all TSHomas. This study aimed to report an extremely rare case of mixed TSHoma coexisted with Graves’ disease(GD) and review the literature. Case presentation A 36-year-old male patient presented with both elevated levels of free triiodothyronine (FT3), free thyroxine (FT4) and insulin-like growth factor 1 (IGF-1), but non-suppressed thyroid-stimulating hormone (TSH) level. His anti-thyroglobulin antibody (TGAb), anti-thyroid peroxidase autoantibody (TPOAb), and thyrotropin receptor antibody (TRAb) were positive. The symptoms of palpitations, hyperhidrosis, heat intolerant, and irritability appeared 2 years before his admission. But he showed neither signs nor symptoms of acromegaly. Contrast-enhanced pituitary magnetic resonance imaging (MRI) showed enlarged pituitary fossa, with an irregular abnormal signal mass. The patient underwent endoscopic partial pituitary resection via transsphenoidal approach. Postoperative pathology suggested mixed pituitary adenoma. The patient had postoperative thyroid function recurrence of hyperthyroidism and the recurrence of TSHoma was confirmed by positron emission tomography-computed tomography (PET-CT) 11months after surgery. After administration of lanreotide, his levels of FT3, FT4, TSH, TPOAb and TGAb became normal, and levels of TRAb and IGF-1 improved. Conclusion A rare case of TSHoma coexisted with GD was reported. When circulating levels of both FT4 and FT3 were upregulated, non-suppressed TSH levels and positive thyroid antibodies were found. Importantly, TSHoma associated with GD should be carefully taken into account to avoid the potential risk of treatment-induced tumor progression.

show abstract

TSH-secreting pituitary adenomas and bone

Losa,

Vassallo,

Frara

et al. 2024

Pituitary

View full text Add to dashboard Cite

Atypical thyrotropin-secreting pituitary microadenoma revealed by severe osteoporosis in a young man

Cited by 5 publications

References 16 publications

High Prevalence of Radiological Vertebral Fractures in Patients With TSH-Secreting Pituitary Adenoma

High Prevalence of Radiological Vertebral Fractures in Patients With TSH-Secreting Pituitary Adenoma

Mixed Thyrotropin-Secreting Pituitary Adenoma Coexisted with Graves' Disease: a case report

TSH-secreting pituitary adenomas and bone

Contact Info

Product

Resources

About