印度一家三级医疗机构中促甲状腺素瘤的治疗结果。

The outcome of TSHoma from a tertiary care institute in India.

作者信息

Dutta Aditya, Jain Nimisha, Rai Ashutosh, Gupta Rahul, Dhandapani Sivashanmugam, Bhansali Anil, Radotra Bishan Das, Ahuja Chirag Kamal, Dutta Pinaki

机构信息

Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Surg Neurol Int. 2021 Apr 14;12:161. doi: 10.25259/SNI_877_2020. eCollection 2021.

DOI:10.25259/SNI_877_2020

PMID:33948331

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8088499/

Abstract

BACKGROUND

Thyroid-stimulating hormone (TSH)-secreting pituitary adenoma (TSHoma) is the rarest functioning pituitary adenoma.

METHODS

A retrospective analysis of eight patients of TSHomas to highlight the presentations, diagnostic challenges, and treatment outcomes.

RESULTS

Median age at diagnosis was 42 years, median latency to diagnosis was 2.5 years, and thyrotoxic and compressive symptoms were the most common presenting symptoms. At presentation, three cases were plurihormonal, six cases were on medical treatment including thyroxine, and two cases were incidentally discovered. Imaging revealed macroadenoma in all cases. Seven cases underwent pituitary surgery, after which three achieved remission. Another case entered remission after adjunctive radiotherapy. Thyrotropin (TSH) immunostaining was demonstrated in six out of seven adenomas.

CONCLUSION

TSHoma is a rare functioning pituitary tumor with both silent and symptomatic presentations. Diagnosis can be established with biochemical and imaging features, even without dynamic tests.

摘要

背景

促甲状腺激素（TSH）分泌型垂体腺瘤（TSH瘤）是最罕见的功能性垂体腺瘤。

方法

对8例TSH瘤患者进行回顾性分析，以突出其临床表现、诊断挑战及治疗结果。

结果

诊断时的中位年龄为42岁，诊断的中位延迟时间为2.5年，甲状腺毒症和压迫症状是最常见的临床表现。就诊时，3例为多激素型，6例正在接受包括甲状腺素在内的药物治疗，2例为偶然发现。影像学检查显示所有病例均为大腺瘤。7例接受了垂体手术，其中3例术后缓解。另一例在辅助放疗后缓解。7例腺瘤中有6例显示促甲状腺激素（TSH）免疫染色。