Clinical outcome and evidence of high rate post-surgical anterior hypopituitarism in a cohort of TSH-secreting adenoma patients: Might somatostatin analogs have a role as first-line therapy?

Gatto, Federico; Grasso, Ludovica F. S.; Nazzari, Elena; Cuny, Thomas; Anania, Pasquale; Somma, Carolina Di; Colao, Annamaria; Zona, Gianluigi; Weryha, G.; Pivonello, Rosario; Ferone, Diego

doi:10.1007/s11102-014-0611-8

Cited by 43 publications

(21 citation statements)

References 21 publications

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“…Recent data from a retrospective study published by Gatto et al report a post-surgical complications rate of 60% as regards TSHomas, while the same figure is only 12% in the case of GHomas matched for age, sex and tumor size. 26 In our presented case, surgical adenomectomy was performed without any complication but resulted in incomplete removal leaving a residual mass of 3 mm in diameter, and recurrence occurred a little over a year postoperatively.…”

Section: Discussion and Review Of The Literaturementioning

confidence: 76%

TSH-secreting pituitary adenomas treated by gamma knife radiosurgery: our case experience and a review of the literature

Mouslech

Somali

Sakali

et al. 2015

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A 43-year-old woman, previously misdiagnosed as having primary hyperthyroidism and treated with antithyroid drugs, presented to us with overt hyperthyroidism, high levels of thyroid hormones and elevated thyroid-stimulating hormone (TSH). Μagnetic resonance imaging (MRI) revealed a pituitary microadenoma extending suprasellarly. the patient responded favorably to initial treatment with somatostatin analogs for 2 years but due to the escape phenomenon, tsH levels escalated and hyperthyroidism relapsed. transsphenoidal adenomectomy was applied but recurrence was again observed due to incomplete tumor removal. Gamma knife radiosurgery was finally employed 5.5 years ago, resulting in complete disease remission without evidence of long-term complications to date. thyrotropin-secreting adenomas (tsHomas) are rare with an estimated prevalence of about one case per million. we retrieved from the literature 14 cases of tsHomas treated by gamma knife radiosurgery and compared the outcomes. our results demonstrate the efficacy and safety of gamma knife radiosurgery for achieving remission in most of the cases, suggesting validation of this technique as an effective treatment option for the management of recurrent tsHomas.

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Section: Discussion and Review Of The Literaturementioning

confidence: 76%

TSH-secreting pituitary adenomas treated by gamma knife radiosurgery: our case experience and a review of the literature

Mouslech

Somali

Sakali

et al. 2015

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“…Экспрессия соматостатиновых рецепторов нередко выявляется в ТТГ-АГ, особенно часто -в смешанных СТГ-ТТГ-секретирующих опухолях. Этим объясняется эффективная способность аналогов соматостатина к снижению уровня ТТГ у пациентов с такими опухолями [28,29]. В нашей работе экспрессия SSt5 выявлена в 46% случаев, и в большинстве случаев она сочеталась с экспрессией СТГ в опухоли, при этом экспрессия SSt5 выявлялась редко.…”

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Clinical and morphological characteristics, diagnostic criteria, and outcomes of surgical treatment of TSH-secreting pituitary adenomas

et al. 2016

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“…Também é consensual o tempo de uso e se é necessário usar até a normalização. A lanreotida é capaz de normalizar o perfil hormonal tireoidiano em 3 a 6 meses (17,(25)(26)(27)(28) . Também podem ser indicados como tratamento único do tumor em casos nos quais a cirurgia não é viável ou contraindicada e nos quadros de falha cirúrgica.…”

Section: Tratamentounclassified

“…O procedimento neurocirúrgico apresenta diversos tipos de complicações, como rinorreia liquórica, infecção, hemorragia, hiponatremia, lesão de carótida, perda de visão epistaxe e hipopituitarismo temporário ou permanente, complicação mais frequente, náuseas e vômitos no pós-operatório e diabetes insípido transitório ou permanente (8,25,28,35) .…”

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Adenoma hipofisário secretor de TSH: uma revisão sistemática / TSH-secreting pituitary adenoma: a systematic review

Souza¹,

Morais

Morais³

et al. 2020

Arq Med Hosp Fac Cienc Med Santa Casa São Paulo

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Introdução: Os adenomas hipofisários são tumores caracterizados pela proliferação de células adeno-hipofisárias produtoras de hormônios tróficos. Dentre eles, os adenomas hipofisários produtores de TSH (TSHomas), neoplasias benignas pouco frequentes, que correspondem a menos do que 3% dos adenomas hipofisários. Método: Pesquisamos os termos TSHomas, tireotropinomas e adenomas pituitários secretores de TSH nas bases Pubmed, Lilacs e Scielo. Incluímos artigos publicados entre 2010 e 2020, sendo excluídos relatos de casos, artigos indisponíveis e que não tratavam sobre o tema. Resultados e discussão: Os TSHomas são tumores fibrosos, monoclonais, com incidência entre 0,015 a 0,03 casos/100.000 habitantes, que se manifestam por hipertireoidismo e sintomas causados por efeito de massa. São diagnosticados diante da elevação de TSH juntamente a hormônios tireoidianos, na presença de alterações neurorradiológicas. O tratamento de primeira escolha consiste na neurocirurgia transesfenoidal, sendo os análogos de somatostatina e a radioterapia alternativas para o manejo de pacientes em que a intervenção cirúrgica é desaconselhada. Conclusão: Os TSHomas são raros, contudo, precisam ser investigados diante da secreção inadequada de TSH.Palavras chave: Adenoma, Hormônios tireoidianos, Neoplasias hipofisárias, Síndrome da secreção inadequada de TSH, Hipertireoidismo centralABSTRACTIntroduction: Pituitary adenomas are tumors characterized by the proliferation of adenohypophysis cells that produce trophic hormones. Among them, TSH-producing pituitary adenomas (TSHomas), uncommon benign neoplasms, whichcorrespond to less than 3% of pituitary adenomas. Method: We searched for the terms TSHomas, thyrotropinomas and pituitary adenomas secreting TSH in the Pubmed, Lilacs and Scielo databases. We included articles published between 2010 and 2020, excluding case reports, articles that were unavailable and did not deal with the topic. Results and discussion: TSHomas are fibrous, monoclonal tumors, with an incidence of 0.015 to 0.03 cases / 100,000 inhabitants, which are manifested by hyperthyroidism and symptoms caused by a mass effect. They are diagnosed with elevated TSH along with thyroid hormones, in the presence of neuroradiological changes. The first-choice treatment consists of transsphenoidal neurosurgery, with somatostatin analogs and radiotherapy being alternatives for the management of patients in whom surgical intervention is not recommended. Conclusion: TSHomas are rare, however, they need to be investigated due to inadequate TSH secretion.Keywords: Adenoma, Thyroid hormones, Pituitary neoplasms, Inappropriate TSH secretion syndrome, Central hypothyroidism

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Clinical outcome and evidence of high rate post-surgical anterior hypopituitarism in a cohort of TSH-secreting adenoma patients: Might somatostatin analogs have a role as first-line therapy?

Cited by 43 publications

References 21 publications

TSH-secreting pituitary adenomas treated by gamma knife radiosurgery: our case experience and a review of the literature

TSH-secreting pituitary adenomas treated by gamma knife radiosurgery: our case experience and a review of the literature

Clinical and morphological characteristics, diagnostic criteria, and outcomes of surgical treatment of TSH-secreting pituitary adenomas

Adenoma hipofisário secretor de TSH: uma revisão sistemática / TSH-secreting pituitary adenoma: a systematic review

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