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Thyrotropin-secreting pituitary carcinoma
A J Mixson1, T C Friedman, D A Katz
1National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland 20892.
The Journal of Clinical Endocrinology and Metabolism
|February 1, 1993
Summary
This case report details the first known carcinoma of a TSH-secreting pituitary adenoma, which metastasized outside the central nervous system. The aggressive tumor showed a notable response to octreotide and chemotherapy, suggesting potential new therapeutic avenues.
Area of Science:
- Endocrinology
- Oncology
- Neurosurgery
Background:
- TSH-secreting pituitary adenomas are rare and typically do not metastasize.
- This study presents the first documented case of a TSH-secreting pituitary adenoma progressing to carcinoma with extra-CNS metastasis.
Observation:
- A 40-year-old woman with a TSH-secreting pituitary adenoma exhibited unusually high alpha-subunit levels.
- Despite surgery and radiation, the tumor recurred and metastasized to the sacrum, lung, and pleura.
- The metastatic pituitary tumor showed a positive response to octreotide and chemotherapy (5-fluorouracil, cytoxan, adriamycin).
Findings:
- The highest recorded alpha-subunit levels in TSH-secreting adenomas may indicate a higher risk of metastasis.
- This case represents the first instance of a TSH-secreting pituitary adenoma metastasizing outside the central nervous system.
Implications:
- Early diagnosis and aggressive treatment are crucial for invasive TSH-secreting pituitary adenomas.
- The response to octreotide and chemotherapy suggests these could be viable treatment options for metastatic pituitary carcinomas.
- Further research into novel therapies for aggressive pituitary tumors is warranted.