Clinical analysis and treatment of thyrotropin-secreting pituitary adenomas

Abstract:

Objective：To describe the diverse clinical and laboratory manifestations of multiple thyrotropin-secreting pituitary adeno－mas cases and to improve diagnostic success. Methods：Clinical characteristics，biochemical indicators，imaging and immunohisto－chemical staining results，surgical procedures，and postoperative outcomes were collected for three cases with identified or suspected thyrotropin-secreting pituitary adenomas. Results：Thyrotoxicosis and thyroid enlargement were the first symptoms and signs in one case，while space occupying effects of tumors were the first symptoms in the other two cases. Levels of thyroxine increased in two cases and those of TSH increased in all three cases. Pituitary magnetic resonance imaging（MRI） in all three cases indicated pituitary macroadenoma. One patient underwent tumorectomy and the other two underwent transnaso-sphenoidal resection of pituitary adenoma. TSH-positive immunohistochemical staining was observed in two cases. During follow-up，two cases of hypopituitarism occurred，both of which improved following hypophyseal hormone therapy. Conclusion：Typical TSHoma can be identified by TSH measurement and pituitary MRI，but clinicians should be aware of atypical clinical manifestations for improved diagnostic accuracy. Treatment should be tailored according to clinical manifestations.