Beck-Peccoz P, Persani L, Mantovani S, Cortelazzi D, Asteria C
Institute of Endocrine Sciences, University of Milan, Ospedale Maggiore IRCCS, Italy.
Metabolism. 1996 Aug;45(8 Suppl 1):75-9. doi: 10.1016/s0026-0495(96)90089-x.
Normal or elevated thyrotropin (TSH) levels in hyperthyroid patients are characteristic of rare TSH-secreting pituitary adenoma (TSH-oma), which is easily detectable by computed tomographic (CT) scan or magnetic resonance imaging (MRI). Other diagnostic aids are an absent/impaired TSH response to thyrotropin-releasing hormone (TRH), discrepant TSH and alpha-subunit responses to TRH, high sex hormone-binding globulin (SHBG) levels, high alpha-subunit levels, and a high alpha-subunit/TSH molar ratio. Familial studies help rule out thyroid hormone resistance (RTH). Surgical removal of TSH-oma leads to clinical and biochemical remission in most patients. In surgical failures, radiotherapy and octreotide treatment have a high success rate. Undetectable TSH 1 week postsurgery suggests a definitive cure, backed up by tests for cosecreted hormones from the adenoma and dynamic tests of TSH suppression.
甲状腺功能亢进患者促甲状腺激素（TSH）水平正常或升高是罕见的分泌TSH的垂体腺瘤（TSH瘤）的特征，通过计算机断层扫描（CT）或磁共振成像（MRI）很容易检测到。其他诊断辅助手段包括TSH对促甲状腺激素释放激素（TRH）无反应/反应受损、TSH和α亚基对TRH的反应不一致、高性激素结合球蛋白（SHBG）水平、高α亚基水平以及高α亚基/TSH摩尔比。家族研究有助于排除甲状腺激素抵抗（RTH）。手术切除TSH瘤可使大多数患者实现临床和生化缓解。对于手术失败的患者，放射治疗和奥曲肽治疗成功率很高。术后1周检测不到TSH提示治愈，腺瘤共分泌激素检测和TSH抑制动态试验可佐证。
