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Thyroid-stimulating hormone pituitary adenomas and hyperthyroidism.

F Grisoli, T Leclercq, J P Winteler

    Surgical Neurology
    |April 1, 1986
    PubMed
    Summary

    Thyroid-stimulating hormone (TSH)-hypersecreting pituitary adenomas cause hyperthyroidism. Early diagnosis and transsphenoidal surgery offer the best chance for cure, especially for non-invasive tumors.

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    Area of Science:

    • Endocrinology
    • Neurosurgery
    • Oncology

    Background:

    • Pituitary adenomas can secrete excess thyroid-stimulating hormone (TSH), leading to hyperthyroidism.
    • This condition, though rare, requires careful diagnosis and management.

    Observation:

    • Six cases of TSH-hypersecreting pituitary adenomas causing hyperthyroidism were analyzed.
    • Tumors varied in invasiveness, with four invasive and two enclosed adenomas.
    • Associated hyperprolactinemia was noted in three patients.

    Findings:

    • Transsphenoidal surgery achieved a cure in two cases of enclosed adenomas without pituitary deficits.
    • For invasive adenomas, surgery and radiation therapy had a low success rate (one cure out of four).
    • Elevated T3 and T4 levels correlated with TSH levels from 2 to 2,000 microU/mL.

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    Implications:

    • Early neuroradiological studies are crucial for diagnosing TSH-hypersecreting adenomas in hyperthyroid patients.
    • Prompt treatment, particularly the transsphenoidal approach for non-invasive tumors, can lead to biological cure.
    • The tendency for these tumors to become invasive underscores the need for early intervention.