Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Kurashiki, Japan.
Front Endocrinol (Lausanne). 2021 Mar 22;12:659076. doi: 10.3389/fendo.2021.659076. eCollection 2021.
Pituitary adenoma producing growth hormone (GH) or thyroid-stimulating hormone (TSH) is characterized by various specific symptoms and/or findings. However, the frequency of pituitary adenoma producing both hormones is relatively low. In this report, we show a case of pituitary adenoma producing both GH and TSH simultaneously.
A 27-year-old woman was diagnosed as acromegaly based on various symptoms and clinical findings. For further examination and treatment, she was hospitalized in our institution. It was likely that this subject had pituitary adenoma producing both GH and TSH. In brain magnetic resonance imaging, there was a giant tumor around pituitary fossa. After the diagnosis of GH- and TSH-producing pituitary adenoma, pituitary tumor resection and cyber knife therapy were performed. In addition, we started additional treatment with somatostatin analog and GH receptor antagonist. After then, GH and insulin-like growth factor (IGF-1) levels were suppressed. After the operation, since thyroid function was not sufficiently suppressed, we started anti-thyroid drug thiamazole. After then, thyroid function was normalized and we stopped thiamazole. In GH and TSH staining, many GH-positive and TSH-positive cells were observed. These findings further confirmed our diagnosis that the pituitary adenoma in this subject produced both GH and TSH simultaneously.
We should bear in mind the possibility of pituitary adenoma producing both GH and TSH at the same time.
分泌生长激素（GH）或促甲状腺激素（TSH）的垂体腺瘤的特点是具有各种特定的症状和/或发现。然而，同时分泌两种激素的垂体腺瘤的频率相对较低。在本报告中，我们展示了一例同时分泌 GH 和 TSH 的垂体腺瘤。
一名 27 岁女性因各种症状和临床发现被诊断为肢端肥大症。为了进一步检查和治疗，她住进了我们的机构。该患者很可能患有同时分泌 GH 和 TSH 的垂体腺瘤。在脑磁共振成像中，蝶鞍周围有一个巨大的肿瘤。在诊断为 GH 和 TSH 分泌性垂体腺瘤后，进行了垂体肿瘤切除术和伽玛刀治疗。此外，我们开始使用生长抑素类似物和 GH 受体拮抗剂进行额外治疗。之后，GH 和胰岛素样生长因子（IGF-1）水平得到抑制。手术后，由于甲状腺功能未得到充分抑制，我们开始使用抗甲状腺药物甲巯咪唑。之后，甲状腺功能恢复正常，我们停止了甲巯咪唑的使用。在 GH 和 TSH 染色中，观察到许多 GH 阳性和 TSH 阳性细胞。这些发现进一步证实了我们的诊断，即该患者的垂体腺瘤同时分泌 GH 和 TSH。
我们应该记住同时分泌 GH 和 TSH 的垂体腺瘤的可能性。
