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TSH-oma

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Pituitary Adenomas

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Abstract

Thyrotropin-secreting pituitary tumors (TSH-omas), accounting for less than 1% of all pituitary tumors, are a rare cause of hyperthyroidism. In the last years, the number of reported cases has increased due to the routine use of ultrasensitive TSH immunometric assays. These new methods allow a clear distinction between patients with suppressed or non-suppressed serum TSH, i.e., between patients with primary hyperthyroidism (Graves’ disease or toxic nodular goiter) and those with central hyperthyroidism (TSH-oma or pituitary resistance to thyroid hormone action, PRTH). The latter two are both characterized by elevated serum levels of free thyroid hormones with measurable TSH levels, making crucial the differential diagnosis for correct patient management. The presence of neurological signs and symptoms or clinical features due to hypersecretion of other pituitary hormones indicates the presence of a TSH-oma, but the definite diagnosis usually relies on specific dynamic testing. Early diagnosis and correct treatment of TSH-omas may prevent the occurrence of neurological and endocrinological complications, thus leading to a better rate of cure. Surgical removal of the pituitary tumor is the first-line treatment, which can be followed by medical treatment with somatostatin analogs and/or radiotherapy.

The chapter has been endorsed by Prof. Davide Carvalho, , Faculty of Medicine, University of Porto, Alameda Prof. Hernani Monteiro, Porto, Portugal

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Authors and Affiliations

  1. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy

    E. Peverelli, E. Giardino, D. Treppiedi, R. Catalano, F. Mangili & G. Mantovani

  2. Endocrinology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

    G. Mantovani

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  1. E. Peverelli
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  2. E. Giardino
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  3. D. Treppiedi
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  4. R. Catalano
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  5. F. Mangili
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  6. G. Mantovani
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Correspondence to G. Mantovani .

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  1. Hermitage Medical Clinic, Dublin, Ireland

    Gianluca Tamagno

  2. Cell Biology, Physiology and Immunology, University of Córdoba, Cordoba, Spain

    Manuel D. Gahete

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Peverelli, E., Giardino, E., Treppiedi, D., Catalano, R., Mangili, F., Mantovani, G. (2022). TSH-oma. In: Tamagno, G., Gahete, M.D. (eds) Pituitary Adenomas. Springer, Cham. https://doi.org/10.1007/978-3-030-90475-3_8

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