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TSH-secreting pituitary adenoma: benefits of pre-operative octreotide.

Wallace IR, Healy E, Cooke RS, Ellis PK, Harper R, Hunter SJ - Endocrinol Diabetes Metab Case Rep (2015)

Bottom Line: TSH-secreting pituitary adenomas are rare and the optimal investigation and management is uncertain.We describe a case of a 43 year-old woman with a TSH-secreting pituitary adenoma, highlighting diagnostic testing and our use, pre-operatively of somatostatin analogue therapy, which induced biochemical euthyroidism and a reduction in tumour size.The differential diagnosis of the syndrome of inappropriate TSH secretion is non-thyroidal illness, medications, assay interference due to heterophilic antibodies, thyroid hormone resistance and TSH-secreting pituitary adenoma.TRH stimulation test and triiodothyronine suppression test assist in differentiating thyroid hormone resistance and TSH-secreting pituitary adenoma.Somatostatin analogue therapy can induce biochemical euthyroidism and reduce tumour size.

View Article: PubMed Central - PubMed

Affiliation: Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital , Grosvenor Road, Belfast, BT12 6BA , UK.

ABSTRACT

Unlabelled: TSH-secreting pituitary adenomas are rare and the optimal investigation and management is uncertain. We describe a case of a 43 year-old woman with a TSH-secreting pituitary adenoma, highlighting diagnostic testing and our use, pre-operatively of somatostatin analogue therapy, which induced biochemical euthyroidism and a reduction in tumour size.

Learning points: The differential diagnosis of the syndrome of inappropriate TSH secretion is non-thyroidal illness, medications, assay interference due to heterophilic antibodies, thyroid hormone resistance and TSH-secreting pituitary adenoma.TRH stimulation test and triiodothyronine suppression test assist in differentiating thyroid hormone resistance and TSH-secreting pituitary adenoma.Somatostatin analogue therapy can induce biochemical euthyroidism and reduce tumour size.

No MeSH data available.


Related in: MedlinePlus

MRI coronal section illustrating a pituitary mass abutting the optic chiasm before octreotide therapy (A) and (B) after 3 months octreotide therapy illustrating a 35% reduction in volume of the pituitary mass.
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fig1: MRI coronal section illustrating a pituitary mass abutting the optic chiasm before octreotide therapy (A) and (B) after 3 months octreotide therapy illustrating a 35% reduction in volume of the pituitary mass.

Mentions: MRI of pituitary illustrated a pituitary macroadenoma (maximal diameter 21 mm) abutting the optic chiasm (Fig. 1A). A test regimen of octreotide 100 μg three times daily for 3 days resulted in suppression of TSH secretion (Table 3).


TSH-secreting pituitary adenoma: benefits of pre-operative octreotide.

Wallace IR, Healy E, Cooke RS, Ellis PK, Harper R, Hunter SJ - Endocrinol Diabetes Metab Case Rep (2015)

MRI coronal section illustrating a pituitary mass abutting the optic chiasm before octreotide therapy (A) and (B) after 3 months octreotide therapy illustrating a 35% reduction in volume of the pituitary mass.
© Copyright Policy - license
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4477234&req=5

fig1: MRI coronal section illustrating a pituitary mass abutting the optic chiasm before octreotide therapy (A) and (B) after 3 months octreotide therapy illustrating a 35% reduction in volume of the pituitary mass.
Mentions: MRI of pituitary illustrated a pituitary macroadenoma (maximal diameter 21 mm) abutting the optic chiasm (Fig. 1A). A test regimen of octreotide 100 μg three times daily for 3 days resulted in suppression of TSH secretion (Table 3).

Bottom Line: TSH-secreting pituitary adenomas are rare and the optimal investigation and management is uncertain.We describe a case of a 43 year-old woman with a TSH-secreting pituitary adenoma, highlighting diagnostic testing and our use, pre-operatively of somatostatin analogue therapy, which induced biochemical euthyroidism and a reduction in tumour size.The differential diagnosis of the syndrome of inappropriate TSH secretion is non-thyroidal illness, medications, assay interference due to heterophilic antibodies, thyroid hormone resistance and TSH-secreting pituitary adenoma.TRH stimulation test and triiodothyronine suppression test assist in differentiating thyroid hormone resistance and TSH-secreting pituitary adenoma.Somatostatin analogue therapy can induce biochemical euthyroidism and reduce tumour size.

View Article: PubMed Central - PubMed

Affiliation: Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital , Grosvenor Road, Belfast, BT12 6BA , UK.

ABSTRACT

Unlabelled: TSH-secreting pituitary adenomas are rare and the optimal investigation and management is uncertain. We describe a case of a 43 year-old woman with a TSH-secreting pituitary adenoma, highlighting diagnostic testing and our use, pre-operatively of somatostatin analogue therapy, which induced biochemical euthyroidism and a reduction in tumour size.

Learning points: The differential diagnosis of the syndrome of inappropriate TSH secretion is non-thyroidal illness, medications, assay interference due to heterophilic antibodies, thyroid hormone resistance and TSH-secreting pituitary adenoma.TRH stimulation test and triiodothyronine suppression test assist in differentiating thyroid hormone resistance and TSH-secreting pituitary adenoma.Somatostatin analogue therapy can induce biochemical euthyroidism and reduce tumour size.

No MeSH data available.


Related in: MedlinePlus