Thyrotropin-secreting pituitary adenomas: clinical and biochemical heterogeneity: case reports and follow-up of nine patients

Article Abstract:

The misdiagnosis of thyrotropin-secreting pituitary adenomas (tumors) is common and has serious consequences. Imbalances of thyrotropin hormone (TSH), a hormone secreted by the pituitary gland that stimulates the thyroid gland, are usually a result of primary thyroid disease. However, since 1970, 70 cases of hyperthyroidism have been diagnosed which have been a result of tumors of the pituitary gland, an important endocrine gland that secretes a number of regulatory hormones involving growth, reproduction and metabolic activities. Because the symptoms may be similar, and the occurrence of this type of tumor is relatively rare, accurate and timely diagnostic procedures are essential for effective treatment. Nine patients with TSH-secreting pituitary tumors are described in whom clinical and biochemical measurements of TSH were made before and after pituitary surgery. The correct diagnosis for all of these patients was delayed and this probably had an adverse effect upon their clinical outcome. The lag between the initial diagnosis of hyperthyroidism and TSH tumor was, on average, about six years. The use of very sensitive TSH assay tests to confirm thyrotoxicosis, a toxic condition caused by hyperactivity of the thyroid gland, is effective in the diagnosis of these tumors. It is expected that this diagnostic technique will help provide more timely diagnosis of this condition and thus reduce mortality, avoid inappropriate therapies, and provide better overall outcomes for these individuals. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Abnormalities, Adenoma, Pituitary gland, Hyperthyroidism

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Octreotide therapy for thyroid-stimulating hormone-secreting pituitary adenomas: a follow-up of 52 patients

Article Abstract:

Otreotide may be an effective treatment for pituitary adenomas characterized by secretion of thyroid-stimulating hormone (TSH). An pituitary adenoma is a benign tumor of the pituitary gland. A study evaluated treatment with otreotide in 52 patients between 16 and 84 years old with a TSH-secreting pituitary adenoma who were treated at 24 medical centers in nine different countries. Among 35 patients in whom treatment with a first dosage of otreotide was evaluated, 33 had a decrease in their blood levels of TSH after their first dosage. Of 33 patients in whom short-term treatment with otreotide was evaluated, 30 had a decrease in their blood levels of TSH after one to two weeks of treatment. The average decrease in TSH levels was 74%. Seventy-three percent of the patients had normal blood levels of thyroid hormones after short-term treatment. Eleven patients had partial shrinkage of the adenoma.

Health aspects, Physiological aspects, Chemotherapy, Pituitary gland tumors, Pituitary tumors, Octreotide acetate

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Bilateral sampling of the internal jugular vein to distinguish between mechanisms of adrenocorticotropic hormone-dependent Cushing syndrome

Article Abstract:

Jugular vein sampling appears to be an effective and less invasive preliminary testing strategy for distinguishing patients with Cushing disease from those with the ectopic adrenocorticotropic hormone (ACTH) syndrome compared to sampling done through the skull. ACTH levels were determined using both techniques in 20 patients with confirmed Cushing disease and one patient with the ACTH syndrome. Eighty percent of the patients were correctly identified using jugular vein sampling. Both test results were negative for the patient with ACTH syndrome.

Measurement, Cushing syndrome, ACTH, Corticotropin

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