Daousi C, Foy Patrick M, Macfarlane Ian A
Clinical Sciences Centre, Lower Lane, Liverpool, L9 7AL, UK.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.07.2008.0541. Epub 2009 Jan 23.
Thyrotropin (TSH)-secreting pituitary adenomas (TSHomas) are rare tumours. It has been suggested that thyroid surgery or radioiodine treatment should not be considered in patients with such tumours as these treatments may facilitate rapid tumour expansion. We studied the effects of thyroid ablative treatment on tumour size and thyroid status in two patients with TSHomas. Patients studied were: (1) a female with a TSHoma who declined to undergo pituitary surgery and underwent a total thyroidectomy instead and (2) a male patient who opted for radioiodine treatment for his recurrent TSHoma. Changes in tumour size on serial magnetic resonance imaging scans, and restoration of euthyroidism were studied. No marked changes in tumour size or features of aggressiveness occurred in these patients over periods of 8 and 12 years. Euthyroidism was restored and maintained in both patients. Ablative thyroid treatment can be a safe and successful option to treat TSHomas.
促甲状腺激素（TSH）分泌型垂体腺瘤（TSH瘤）是罕见的肿瘤。有人提出，患有此类肿瘤的患者不应考虑进行甲状腺手术或放射性碘治疗，因为这些治疗可能会促进肿瘤快速生长。我们研究了甲状腺消融治疗对两名TSH瘤患者肿瘤大小和甲状腺状态的影响。研究的患者为：（1）一名患有TSH瘤的女性，她拒绝接受垂体手术，而是接受了全甲状腺切除术；（2）一名男性患者，他选择对复发性TSH瘤进行放射性碘治疗。我们研究了连续磁共振成像扫描中肿瘤大小的变化以及甲状腺功能正常的恢复情况。在8年和12年的时间里，这些患者的肿瘤大小或侵袭性特征均未发生明显变化。两名患者均恢复并维持了甲状腺功能正常。甲状腺消融治疗可以是治疗TSH瘤的一种安全且成功的选择。
