Thyroid-Stimulating Hormone-Secreting Pituitary Adenomas : Single Institutional Experience of 14 Consecutive Cases
Open Access
- 1 July 2020
- journal article
- research article
- Published by Korean Neurosurgical Society in Journal of Korean Neurosurgical Society
- Vol. 63 (4), 495-503
- https://doi.org/10.3340/jkns.2019.0169
Abstract
Objective : Thyroid-stimulating hormone (TSH)-secreting pituitary adenoma (PA) is an extremely rare functioning form of PA that accounts for 0.7-2% of all such cases. The previously reported outcomes of the surgical removal of TSH-PA are poor. Owing to its extremely low incidence, most available reports on TSH-PA are case reports or small case series. Thus, we investigated the clinical and endocrinological outcomes of surgically treated TSH-PA through our institutional series. Methods : We retrospectively reviewed 14 consecutive cases of surgically treated TSH-PA, focusing on the clinical, radiological, surgical, and endocrinological data. Results : There were seven male (50%) and seven female (50%) patients. The mean age was 42.5 years (range, 19-63). The mean tumor size was 16.6 mm (range, 4-30). Optic chiasm compression was noted in six patients (42.9%), and no patient showed cavernous sinus invasion. Thirteen of 14 patients (92.8%) underwent transnasal transsphenoidal approach (TSA), and one patient underwent TSA followed by transcranial approach for residual tumor removal. Thirteen of 14 patients (92.8%) showed endocrinological remission; all patients who experienced remission showed subnormal levels of TSH (<0.4 mu U/mL) on postoperative day 2. Recurrence occurred in two patients (14.2%). One patient underwent subsequent revision transnasal TSA for recurrent tumor removal, and the other patient underwent gamma knife radiosurgery for recurrence. Conclusion : Surgical treatment showed excellent surgical outcomes. The TSH level in the immediate postoperative period may be a predictor for endocrinological remission.Keywords
This publication has 22 references indexed in Scilit:
- Clinicopathological characteristics and therapeutic outcomes in thyrotropin-secreting pituitary adenomas: a single-center study of 90 casesJournal of Neurosurgery, 2014
- The incidence rate of pituitary adenomas in western Sweden for the period 2001–2011Acta Endocrinologica, 2014
- National Incidence and Prevalence of TSH-Secreting Pituitary Adenomas in SwedenJournal of Clinical Endocrinology & Metabolism, 2013
- 2013 European Thyroid Association Guidelines for the Diagnosis and Treatment of Thyrotropin-Secreting Pituitary TumorsEuropean Thyroid Journal, 2013
- Thyrotropin-secreting pituitary adenomas: diagnosis and management of patients from one Chinese centerWiener klinische Wochenschrift, 2012
- Clinical aspects and therapeutic outcome in thyrotropin-secreting pituitary adenomas: A single center experienceJournal of Endocrinological Investigation, 2009
- Long-term surgical outcome in 16 patients with thyrotropin pituitary adenomaJournal of Neurosurgery, 2000
- Thyrotropin-Secreting Pituitary Tumors: Diagnostic Criteria, Thyroid Hormone Sensitivity, and Treatment Outcome in 25 Patients Followed at the National Institutes of HealthJournal of Clinical Endocrinology & Metabolism, 1999
- Basic fibroblast growth factor expression by two prolactin and thyrotropin-producing pituitary adenomasEndocrine Pathology, 1995
- Pituitary Adenomas with Invasion of the Cavernous Sinus SpaceNeurosurgery, 1993