2013 European Thyroid Association Guidelines for the Diagnosis and Treatment of Thyrotropin-Secreting Pituitary Tumors
Authors:
Open Access
- 7 May 2013
- journal article
- research article
- Published by Bioscientifica in European Thyroid Journal
- Vol. 2 (2) , 76-82
Abstract
Hyperthyroidism is mainly due to autoimmune thyroid disorders or toxic goiter, and very rarely to the presence of thyrotropin (TSH)-secreting pituitary adenomas (TSHomas). These tumors are characterized by high levels of circulating free thyroid hormones (FT4 and FT3) in the presence of nonsuppressed serum TSH concentrations. Failure to correctly diagnose TSHomas may result in inappropriate thyroid ablation, which results in a significant increase of pituitary tumor mass. The diagnosis is mainly achieved by measuring TSH after T3 suppression and TRH stimulation tests. These dynamic tests, together with pituitary imaging and genetic testing are useful in distinguishing TSHomas from the syndromes of resistance to thyroid hormone action. The treatment of choice is surgery. In cases of surgical failure, somatostatin analogs have been found to be effective in normalizing TSH secretion in more than 90% of patients.Keywords
This publication has 35 references indexed in Scilit:
- Incidence of Pituitary Adenomas in Northern Finland in 1992–2007The Journal of Clinical Endocrinology & Metabolism, 2010
- Prevalence of pituitary adenomas: a community‐based, cross‐sectional study in Banbury (Oxfordshire, UK)Clinical Endocrinology, 2010
- TSH-secreting adenomasBest Practice & Research Clinical Endocrinology & Metabolism, 2009
- Grades of Recommendation for Antithrombotic AgentsChest, 2008
- Different responses to chronic somatostatin analogues in patients with central hyperthyroidismClinical Endocrinology, 2004
- Thyrotropin-secreting pituitary adenomas. Clinical and biological heterogeneity and current treatmentJournal of Neuro-Oncology, 2001
- An Abnormality of Thyroid Hormone Receptor Expression May Explain Abnormal Thyrotropin Production in Thyrotropin-Secreting Pituitary TumorsThyroid®, 1998
- Multiple endocrine neoplasia type 1 in patients with recognized pituitary tumours of different typesClinical Endocrinology, 1997
- Screening of candidate oncogenes in human thyrotroph tumors: absence of activating mutations of the G alpha q, G alpha 11, G alpha s, or thyrotropin-releasing hormone receptor genes.The Journal of Clinical Endocrinology & Metabolism, 1996
- Thyrotropin-induced hyperthyroidism caused by selective pituitary resistance to thyroid hormone. A new syndrome of "inappropriate secretion of TSH".Journal of Clinical Investigation, 1975