Gasparoni P, Rubello D, Persani L, Beck-Peccoz P
Department of Endocrinology, University Hospital of Castelfranco Veneto, Italy.
Thyroid. 1998 Feb;8(2):181-3. doi: 10.1089/thy.1998.8.181.
We report here an unusual case of association between thyrotropin (TSH)-secreting pituitary adenoma and papillary thyroid carcinoma in a young female patient. Serum TSH levels did not significantly change after both stimulatory (thyrotropin-releasing hormone [TRH], domperidone) and inhibitory (bromocriptine levotriiodothyronine, [LT3], levothyroxine [LT4], LT4 plus LT3) tests, while a 67% decrease of serum TSH levels was obtained after acute administration of a somatostatin analog (SMS 201-995, 100 microg s.c.). Serum alpha-subunit levels and the alpha-subunit/TSH molar ratio were clearly elevated. Magnetic resonance imaging (MRI) revealed the presence of a pituitary adenoma (1 cm in diameter). Pitfalls arising from the failure to inhibit TSH secretion in a patient thyroidectomized for papillary cancer are discussed.
我们在此报告一例年轻女性患者中促甲状腺激素（TSH）分泌型垂体腺瘤与甲状腺乳头状癌相关的罕见病例。在刺激试验（促甲状腺激素释放激素[TRH]、多潘立酮）和抑制试验（溴隐亭、左三碘甲状腺原氨酸[LT3]、左甲状腺素[LT4]、LT4加LT3）后，血清TSH水平均无显著变化，而在急性给予生长抑素类似物（SMS 201 - 995，100μg皮下注射）后，血清TSH水平下降了67%。血清α亚基水平及α亚基/TSH摩尔比明显升高。磁共振成像（MRI）显示存在垂体腺瘤（直径1 cm）。讨论了因未能抑制已行甲状腺乳头状癌甲状腺切除术患者的TSH分泌而导致的陷阱。
