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Review

Evaluation and Management of Thyrotropin-Secreting Pituitary Adenomas

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Pages 163-171 | Published online: 12 Dec 2014
 

Abstract

Thyrotropin (TSH)-secreting pituitary adenomas are uncommon pituitary neoplasms. They have been increasingly recognized with the advent of ultrasensitive TSH assays and advanced pituitary imaging. Clinically, patients may often present with signs and symptoms of hyperthyroidism. Some patients may present with tumor-related local mass effect, anterior hypopituitarism or syndromes related to co-secretion of other pituitary hormones. Their diagnosis and differential diagnosis from other causes of hyperthyroidism and ‘inappropriate TSH secretion’ often presents a clinical challenge. While trans-sphenoidal pituitary adenomectomy remains the therapeutic modality of choice, medical treatment with somatostatin receptor agonists or dopamine agonists is often needed as adjunctive therapy or perhaps as a potential alternative to surgery. Radiation therapy to the sella may be advised as a third-line therapy.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.

No writing assistance was utilized in the production of this manuscript.

Notes

5FU: 5-fluorouracil; T3: Triiodothyronine; T4: Thyroxine; TBG: Thyroid-binding globulin; TH: Thyroid hormone; TSH: Thyrotropin.

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