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Thyrotropin-secreting tumor "TSH-PitNET": From diagnosis to treatment.

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Affiliations

  • 1. Département d'endocrinologie-diabétologie nutrition, CHU d'Angers, 4, rue larrey, 49100 Angers, France; Laboratoire MITOVASC, UMR CNRS 6015, Inserm 1083, Université d'Angers, rue Roger Amsler, 49100 Angers, France; Centre de référence des maladies rares de la Thyroïde et des Récepteurs Hormonaux, Endo-ERN centre for rare endocrine diseases. CHU d'Angers, 4, rue larrey, 49100 Angers, France.
      Authors
    • Briet C 1
    • Suteau V 1
    • Rodien P 1
    (3 authors)
  • 2. Département d'endocrinologie-diabétologie nutrition, CHU d'Angers, 4, rue larrey, 49100 Angers, France; Centre de référence des maladies rares de la Thyroïde et des Récepteurs Hormonaux, Endo-ERN centre for rare endocrine diseases. CHU d'Angers, 4, rue larrey, 49100 Angers, France.
      Authors
    • Illouz F 2
    (1 author)

Annales D'endocrinologie, 27 Jan 2023, 84(4):407-412
https://doi.org/10.1016/j.ando.2023.01.004 PMID: 36716819 

Review

Abstract 

Thyrotropic adenomas (TSH-PitNET) are the rarest pituitary tumours. Most TSH-PitNETs are secreting adenoma, with a biological picture of inappropriate TSH secretion (moderately elevated TSH, elevated FT3 and FT4). Patients present most often clinical hyperthyroidism, but with more moderate symptoms than in peripheral hyperthyroidism. Biological diagnosis is not always easy. The main differential diagnoses are interfering antibody assay interactions, dysalbuminemia and thyroid hormone resistance syndrome. Misdiagnosis is common. However, the diagnosis is easier when macroadenomas are involved (80% of cases), with symptoms of optic chiasm compression, headache and signs of hypopituitarism. Treatment is initially based on surgery. In case of failure, somatostatin analogues are very effective in controlling tumor volume and secretion, although there is a risk of thyroid insufficiency, which is usually transient.

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Read article at publisher's site: https://doi.org/10.1016/j.ando.2023.01.004

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