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Thyrotropin-producing pituitary adenomas

T Mindermann1, C B Wilson

  • 1Department of Neurological Surgery, School of Medicine, University of California, San Francisco.

Journal of Neurosurgery
|October 1, 1993
PubMed
Summary
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Thyrotropin (TSH)-producing pituitary adenomas are more common than previously thought, particularly in women. These tumors, often macroadenomas, are linked to serious cardiovascular and neurological issues.

Area of Science:

  • Endocrinology
  • Neurosurgery
  • Oncology

Background:

  • Thyrotropin (TSH)-producing pituitary adenomas are rare tumors.
  • Understanding their biology is crucial for effective patient management.

Purpose of the Study:

  • To evaluate the clinical characteristics and biological behavior of TSH-producing pituitary adenomas.
  • To assess the incidence, reoperation rates, and associated complications.

Main Methods:

  • Retrospective chart review of 19 patients who underwent transsphenoidal surgery for TSH-producing pituitary adenomas.
  • Analysis of patient demographics, tumor characteristics, treatment outcomes, and complications over a 15-year period.

Main Results:

  • TSH-producing adenomas constituted 2.8% of pituitary adenomas treated at UCSF between 1989-1991.

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  • Reoperation rate for tumor recurrence was 10.5%.
  • Women presented younger with longer symptom duration but smaller, less invasive tumors compared to men. Tumors were exclusively macroadenomas, with 50% being plurihormonal (including TSH and ACTH). Significant cardiovascular (46%) and neurological (16%) complications were noted.

    • Conclusions:

    • TSH-producing pituitary adenomas are more prevalent than previously assumed.
    • These tumors exhibit distinct biological differences between sexes and are associated with severe cardiovascular and neurological complications, necessitating vigilant monitoring and management.