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Usefulness of thyrotropin-releasing hormone test, SMS 201–995, and bromocriptine in the diagnosis and treatment of gonadotropin-secreting pituitary adenomas

Journal of Endocrinological Investigation volume 17, pages 99–104 (1994)Cite this article

Abstract

Five patients with gonadotropin-secreting pituitary adenomas were studied. The utility of gonadotropin response to TRH stimulation in the diagnosis and follow-up of these tumors was evaluated, as well as the effects of somatostatin analogue SMS 201–995 and bromocriptine on gonadotropin release. Three patients had FSH and LH secreting adenomas while the other two tumors secreted FSH and a-subunit. Transsphenoidal resection of the pituitary adenomas were performed in all patients. Following preoperative TRH administration (400 μg iv), marked increases were observed in FSH levels in two cases, in LH levels in three and in α-subunit in one. The FSH and LH responses to this stimulus persisted in the same patients after surgery. Following acute bromocriptine administration (5 mg orally), FSH was reduced in all cases by 19% to 46%; LH in three cases by 50–67% and α-subunit in one by 33%. In patient no. 5, with persistent high FSH levels in the immedi.ate postoperative period, long-term bromocriptine treatment was administered (15 mg/d orally), resulting in normalization of FSH levels 6 months later, although the size of the tumor was not reduced. After acute SMS 201–995 administration (100 μg sc) FSH decreased in two cases by 38% and 76%, LH in three by 30–56% and a-subunit in one by 20%. We conclude that gonadotropin response to TRH stimulation is useful in the diagnosis and follow-up of patients with gonadotroph adenoma. Bromocriptine and SMS 201–995 may be effective as coadjuvant treatment following surgery and radiotherapy in these patients, although long-term studies will be necessary to confirm these proposals.

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References

  1. Snyder P.J. Gonadotroph cell adenomas of the pituitary. Endocr. Rev. 6: 552, 1985.

    PubMed  Article  CAS  Google Scholar 

  2. Horvath E., Kovacs K. Gonadotroph adenomas of the human pituitary: structural dichotomy. Am. J. Pathol. 117: 429, 1984.

    PubMed Central  PubMed  CAS  Google Scholar 

  3. Beckers A., Stevenaert A., Mashiter K., Hennen G. Follicle-stimulating hormone secreting pituitary adenomas. J. Clin. Endocrinol. Metab. 61: 525, 1985.

    PubMed  Article  CAS  Google Scholar 

  4. Kwekkeboom D.J., De Jong F.H., Lamberts S.W.J. Gonadotropin release by clinically nonfunctioning and gonadotroph pituitary adenomas in vivo and in vitro: relation to sex and effects of thyrotropin-releasing hormone, gonadotropin-releasing hormone, and bromocriptine. J. Clin. Endocrinol. Metab. 68: 1128, 1989.

    PubMed  Article  CAS  Google Scholar 

  5. Black P., Hsu D., Klibanski A., Kliman B., Jameson J.L., Ridgway EC, Hedle-Whyte T., Zervas N.T. Hormone production in clinically nonfunctioning pituitary adenomas. J. Neurosurg. 66: 244, 1987.

    PubMed  Article  CAS  Google Scholar 

  6. Oppenheim D.S., Klibanski A. Medical therapy of glycoprotein hormone-secreting pituitary tumors. Endocrinol. Metab. Clin. North. Am. 18: 339, 1984.

    Google Scholar 

  7. Daneshdoost L., Aldrich T.K., Prezant D.J., Sinnett M.J., Enden J.B., Williams M.H. Recognition of gonadotroph adenomas in women. N. Engl. J. Med. 324: 589, 1991.

    PubMed  Article  CAS  Google Scholar 

  8. Molitch M.E. Gonadotroph-cell pituitary adenomas. N. Engl. J. Med. 324: 626, 1991.

    PubMed  Article  CAS  Google Scholar 

  9. Klibanski A., Zervas N.T. Diagnosis and management of hormone secreting pituitary adenomas. N. Engl. J. Med. 324: 822, 1991.

    PubMed  Article  CAS  Google Scholar 

  10. Berezin M., Olchovsky D., Pines A., Tadmor R., Lunenfeld B. Reduction of follicle-stimulating hormone (FSH) secretion in FSH-producing pituitary adenoma by bromocriptine. J. Clin. Endocrinol. Metab. 59: 1220, 1984.

    PubMed  Article  CAS  Google Scholar 

  11. Vance M.L., Ridgway E.C., Thorner M.O. Follicle-stimulating hormone and α-subunit-secreting pituitary tumor treated with bromocriptine. J. Clin. Endocrinol. Metab. 61: 580, 1985.

    PubMed  Article  CAS  Google Scholar 

  12. Chapman A.J., McFarlane I.A., Shalet S.M., Beardwell C.G., Dutton J., Sutton M.L. Discordant serum α-subunit and FSH concentrations in a woman with a pituitary tumor. Clin. Endocrinol. (Oxf.) 21: 123, 1984.

    Article  CAS  Google Scholar 

  13. Klibanski A., Deutsch P.J., Jameson J.L., Ridgway E.C., Crowley W.F., Hsu D.W., Habener J.F., Black P. Luteinizing hormone-secreting pituitary tumor: biosynthetic characterization and and clinical studies. J. Clin. Endocrinol. Metab. 64: 536, 1987.

    PubMed  Article  CAS  Google Scholar 

  14. Lamberts S.W.J., Verleun T., Oosterom R., Hofland L., van Ginkel L.A., Loeber J.G., van Vroonhoven C.C.J., Stepanko S.Z., de Jong F.M. The effects of bromocriptine, thyrotropin-releasing hormone and gonadotropin-releasing hormone on hormone secretion by gonadotropin-secreting pituitary adenomas in vivo and in vitro. J. Clin. Endocrinol. Metab. 64: 524, 1987.

    PubMed  Article  CAS  Google Scholar 

  15. McFarlane I.A., Beardwell C.G., Shalet S.M., Ainslie G., Rankin E. Glycoprotein hormone α-subunit secretion in patients with pituitary adenomas: influence of TRH, LRH and bromocriptine. Acta Endocrinol. (Copenh) 99: 487, 1982.

    Google Scholar 

  16. Vos P., Croughs R.J.M., Thijssen J.H.H., van’t Verlaat, van Ginkel L.A. Response of luteinizing hormone secreting pituitary adenoma to a long-acting somatostatin analogue. Acta Endocrinol. (Copenh.) 118: 587, 1988.

    CAS  Google Scholar 

  17. Allyn R., Bernstein R., Chynn K.Y., Kourides I.A. Reduction in size of a thyrotropin and gonadotropin-secreting pituitary adenoma treated with octreotide acetate (somatostatin analog). J. Clin. Endocrinol. Metab. 74: 690, 1992.

    Google Scholar 

  18. Harris R.I., Schatz N.J., Gennarelli T., Savino P.J., Cobbs W.H., Snyder P.J. Follicle-stimulating hormone-secreting pituitary adenomas: correlation of reduction of adenoma size with reduction of hormonal hypersecretion after transsphenoidal surgery. J. Clin. Endocrinol. Metab. 56: 1288, 1983.

    PubMed  Article  CAS  Google Scholar 

  19. White M.C., Daniels M., Newland P., Thompson C.J., Cook D., Dewar J., Perry R., Jewitt R., Mathias D., Murdoch A.P., Kendall-Taylor P. LH and FSH secretion and responses to GnRH and TRH in patients with clinically functionless pituitary adenomas. Clin. Endocrinol. (Oxf.) 32: 681, 1990.

    Article  CAS  Google Scholar 

  20. Snyder P.J., Muzyka R., Johnson J., Utiger R.D. Thyrotropin-releasing hormone provokes abnormal follicle-stimulating hormone responses in men who have pituitary adenomas and FSH hypersecretion. J. Clin. Endocrinol. Metab. 51: 744, 1980.

    PubMed  Article  CAS  Google Scholar 

  21. Demura R., Jibiki K., Kubo O., Odagiri E., Demura H., Kitamura K., Shizume K. The significance of alpha-subunit as a tumor marker for gonadotropin-producing pituitary adenomas. J. Clin. Endocrinol. Metab. 63: 564, 1986.

    PubMed  Article  CAS  Google Scholar 

  22. Klibanski A., Alexander J.M., Bikkal H.A., Hsu D.W., Swearigen B., Zervas N.T. Somatostatin regulation of glycoprotein hormone and free subunit secretion in clinically nonfunctioning and somatotroph adenomas in vitro. J. Clin. Endocrinol. Metab. 73: 1248, 1991.

    PubMed  Article  CAS  Google Scholar 

  23. Samuels M.H., Henry P., Ridgway E.C. Effects of dopamine and somatostatin on pulsatile pituitary glycoprotein secretion. J. Clin. Endocrinol. Metab. 74: 217, 1992.

    PubMed  CAS  Google Scholar 

  24. Galway A.B., Hsueh A.J.W., Daneshdoost L., Zhou M., Pavlou S.N., Snyder P.J. Gonadotroph adenomas in men produce biologically active follicle-stimulating hormone. J. Clin. Endocrinol. Metab. 71: 907, 1990.

    PubMed  Article  CAS  Google Scholar 

  25. Samuels M.H., Henry P., Kleinschmidt-Demasters B.K., Lillehei K., Ridgway E.C. Pulsatile glycoprotein hormone secretion in glycoprotein-producing pituitary tumors. J. Clin. Endocrinol. Metab. 73: 1281, 1991.

    PubMed  Article  CAS  Google Scholar 

  26. Beck-Peccoz P., Bassetti M., Spada A., Medri G., Arosio M., Giannastasio G., Faglia G. Glycoprotein hormorne alpha-subunit response to growth hormone-releasing hormone in patients with active acromegaly. Evidence for alpha-subunit and GH coexistence in the same tumoral cell. J. Clin. Endocrinol. Metab. 61: 541, 1985.

    CAS  Google Scholar 

  27. Ishibashi M., Yamaji T., Takaku F., Teramoto A., Fukushima T. Secretion of glycoprotein hormone α-subunit by pituitary tumors. J. Clin. Endocrinol. Metab. 64: 1187, 1987.

    PubMed  Article  CAS  Google Scholar 

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Affiliations

  1. Department of Endocrinology, Hospital Puerta de Hierro, c/o San Martin de Porres 4, 28035, Madrid, Spain

    C. Blanco Dr., T. Lucas, J. Alcañiz, N. Davila, P. Serrano, B. Barcelò & J. Estrada

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  1. C. Blanco Dr.
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  2. T. Lucas
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  3. J. Alcañiz
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Blanco, C., Lucas, T., Alcañiz, J. et al. Usefulness of thyrotropin-releasing hormone test, SMS 201–995, and bromocriptine in the diagnosis and treatment of gonadotropin-secreting pituitary adenomas. J Endocrinol Invest 17, 99–104 (1994). https://doi.org/10.1007/BF03347693

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  • DOI: https://doi.org/10.1007/BF03347693

Key-words

  • Gonadotroph adenomas
  • α-subunit
  • TRH test
  • bromocriptine
  • SMS 201-995