Calvo Romero J M, Morales Pérez F, Alvarez Barreiro J A, Díaz Pérez de Madrid J
Servicio de Medicina Interna, Hospital Regional Universitario Infanta Cristina, Badajoz.
Rev Clin Esp. 1999 May;199(5):285-7.
Thyrotropin (TSH)-producing adenoma or TSH-oma is an uncommon entity. Most cases correspond to macroadenomas, and microadenomas are exceptional. The differential diagnosis should include mainly hypophyseal resistance to thyroid hormones, which can be difficult because of normal findings of imaging studies of the pituitary gland in some cases of TSH-oma and also because of the clinical and biochemical heterogeneity of both entities. Hypophyseal surgery is the treatment of choice for TSH-omas, although clinical and biochemical recovery of hyperthyroidism is not achieved in a considerable proportion of cases. When surgery fails or is contraindicated, radiotherapy and somatostatine analogues are therapeutic alternatives. We report here two cases of TSH-producing microadenoma which were confirmed after hypophyseal surgery.
促甲状腺激素(TSH)分泌性腺瘤或TSH瘤是一种罕见的疾病。大多数病例为大腺瘤,微腺瘤则较为罕见。鉴别诊断主要应包括垂体对甲状腺激素的抵抗,这可能具有挑战性,因为在某些TSH瘤病例中垂体的影像学检查结果正常,而且这两种疾病在临床和生化方面存在异质性。垂体手术是TSH瘤的首选治疗方法,不过相当一部分病例无法实现甲亢的临床和生化恢复。当手术失败或存在禁忌时,放疗和生长抑素类似物是可供选择的治疗方法。我们在此报告两例经垂体手术后确诊的促甲状腺激素分泌性微腺瘤病例。