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Cited by 274Pituitary Gland Disorders and TreatmentsNeuroendocrine Tumor Research AdvancesAdrenal and Paraganglionic Tumors

The changing spectrum of TSH-secreting pituitary adenomas: diagnosis and management in 43 patients

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Socin, HV, Chanson, P, Delemer, B, Tabarin, A, Rohmer, V, Mockel, J, Stevenaert, A, Beckers, A·2003·European Journal of Endocrinology
DOI 10.1530/eje.0.1480433
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Abstract

OBJECTIVE: Our aim was to report the recent changes in diagnosis and management of TSH-secreting pituitary adenomas. METHODS: We retrieved 43 consecutive patients with TSH-secreting pituitary tumors (23 male and 20 female) among 4400 pituitary adenomas followed between 1976 and 2001 in six Belgian and French centers. RESULTS: TSH was elevated in 18/43 and alpha subunit in 13/32 patients. In patients with intact thyroid (n=30), mean free tri-iodothyronine was 13.1 pmol/l (range 3.5-23) and mean free thyroxine was 38.4 pmol/l (range 10.2-62.7). Hyperprolactinemia and acromegaly were associated in 9/43 and 8/43 cases. The number of associated hypersecretions was higher in macroadenomas than in microadenomas (Chi square = 11.2, P<0.01). Two women had sporadic multiple endocrine neoplasia type 1-associated syndrome. The proportion of microadenomas versus macroadenomas was 1/11 (period 1974-1986) and 8/32 (period 1987-2001). Bilateral petrosal sinus sampling, (111)In-pentreotide scintigraphy and ((11)C)-l-methionine positron emission tomography scan confirmed diagnosis in four questionable microadenomas. Macroadenomas with extrasellar extension (31 cases) had a tendency to be medially located. Medical treatment with somatostatin analogs was initiated as first-line treatment in 26 patients. TSH levels were reduced by more than 50% in 23/26 cases. A tumoral shrinkage of more than 20% was observed in 5/13 cases. Surgery was performed in 36 patients. After 1 year, 21 of them (58.3%) met the criteria of surgical favorable outcome. Pituitary radiotherapy (n=8) and somatostatin analogs allowed normalization in cases not cured by surgery. CONCLUSION: Ultrasensitive methods for TSH measurement led to an earlier recognition of TSH-secreting pituitary tumors. In this series, we observed that TSH-secreting pituitary tumors are today more frequently found at the stage of microadenomas, medially located, without associated hypersecretions and needing new exploration methods as compared with older series. This changing spectrum in the presentation of TSH-secreting pituitary tumors and the excellent response to somatostatin analogs has been accompanied by an improvement in the prognosis of the disease.

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Research works printed but not linked: 3

  1. Mindermann, T., Wilson, C.B., Thyrotrophin-producing pituitary adenomas (1993) Journal of Neurosurgery, 79, pp. 521-527
  2. Muhr, C., Bergström, M., Lundberg, P.O., Langström, B., Positron emission tomography in the evaluation effects in pituitary adenomas (1990) Journal of Endocrinological Investigation, 13 (SUPPL. 2), pp. S79. , (Abstract)
  3. Bétéa, D., Valdes Socin, H., Beckers, A., Pituitary pathology and MEN1 (2000) Annales D' Endocrinologie, 61, pp. 214-223

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Authors
Socin, H., Chanson, P., Delemer, B., Tabarin, A., Rohmer, V, Mockel, J., Stevenaert, A., & Beckers, A.
Affiliations
  • Centre Hospitalier Universitaire de Liège (BE)
  • Bicêtre Hospital (FR)
  • Centre Hospitalier Universitaire de Reims (FR)
  • Centre Hospitalier Universitaire de Bordeaux (FR)
  • Centre Hospitalier Universitaire d'Angers (FR)
  • Erasmus Hospital (BE)
Corresponding author
Beckers, A
ORCID
Venue
European Journal of Endocrinology
Publisher
Oxford University Press (OUP)
Published
2003-04-01
Volume
148
Issue
4
Pages
433-442
ISSN
  • 0804-4643 (ISSN-L)
  • 1479-683X
DOI
10.1530/eje.0.1480433
OpenAlex
W2098339965
Cited by
274
References
28
Citations by year
2026: 4 · 2025: 6 · 2024: 10 · 2023: 11 · 2022: 19 · 2021: 12 · 2020: 11 · 2019: 11 · 2018: 23 · 2017: 15 · 2016: 5 · 2015: 17 · 2014: 16 · 2013: 16 · 2012: 11
FWCI
4.48
Type
journal article
Language
en
Open access
Licence
other-oa
Locations
  • European Journal of Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
  • Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion)
  • ORBi (University of Liège) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
  • Health Sciences › Medicine › Epidemiology › Neuroendocrine Tumor Research Advances
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
Keywords
TSH-secreting pituitary adenoma, TSHoma, alpha subunit, hyperprolactinemia, acromegaly, multiple endocrine neoplasia type 1, somatostatin analogues, pituitary surgery, pituitary radiotherapy, somatostatin receptor scintigraphy, methionine PET, tumor shrinkage
MeSH terms
Acromegaly, Adenoma, Adult, Aged, Aged, 80 and over, Belgium, Female, France, Humans, Hyperprolactinemia, Hyperthyroidism, Insulin-Like Growth Factor I, Magnetic Resonance Imaging, Male, Middle Aged, Mutation, Pituitary Neoplasms, Prolactin, Surgical Procedures, Operative, Thyrotropin, Thyroxine, Tomography, Emission-Computed, Tomography, X-Ray Computed, Triiodothyronine, Octreotide, Treatment Outcome, Multiple Endocrine Neoplasia Type 1, Antineoplastic Agents, Hormonal

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