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Pathological study of thyrotropin-secreting pituitary adenoma: plurihormonality and medical treatment

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Abstract

Thyrotropin (TSH)-secreting adenomas are rare and, as most adenomas are large, invasive and difficult to cure by surgery only, many require additional medical treatment. Many TSH-secreting adenomas cosecrete growth hormone (GH) and/or prolactin (PRL). We evaluated the relationship between pathology and the effect of dopamine agonist bromocriptine and somatostatin analogue octreotide in 20 operated patients with TSH-secreting adenomas. The four men and 16 women ranged in age from 23 to 62 years; three had clinically overt acromegaly; two manifested galactorrhea-amenorrhea. Endocrinologically, elevated serum GH, and/or IGF-1 were observed in six patients and elevated serum PRL was observed in eight. Immunohistochemically, 16 of the 20 adenomas were positive for GH and/or PRL (GH-positive, n=13; PRL-positive, n=9). Pituitary-specific transcription factor Pit-1 was demonstrated in the nuclei of all adenoma cells. Octreotide tests showed suppression of serum TSH (<50%) in ten of 14 patients. Preoperative octreotide treatment effectively reduced serum TSH and tumor size in two patients. Electron micrographs of octreotide-treated TSH-secreting adenomas showed shrinkage of the cytoplasm and diffuse distribution of secretory granules. Our study suggests that cosecretion of GH and/or PRL from TSH-secreting adenoma has no correlation with response of tumor cells to medical treatment.

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Authors and Affiliations

  1. Department of Neurosurgery, Nippon Medical School, 1-1-5 Sendagi Bunkyo-ku, 113–8603, Tokyo, Japan

    Akira Teramoto, Naoko Sanno, Shigeyuki Tahara & Yoshiyuki R Osamura

  2. Department of Pathology, Tokai University School of Medicine, Boseidai Isehara, 259–1122, Kanagawa, Japan

    Akira Teramoto, Naoko Sanno, Shigeyuki Tahara & Yoshiyuki R Osamura

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  1. Akira Teramoto
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  2. Naoko Sanno
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  3. Shigeyuki Tahara
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  4. Yoshiyuki R Osamura
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Correspondence to Akira Teramoto.

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Teramoto, A., Sanno, N., Tahara, S. et al. Pathological study of thyrotropin-secreting pituitary adenoma: plurihormonality and medical treatment. Acta Neuropathol 108, 147–153 (2004). https://doi.org/10.1007/s00401-004-0863-x

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  • DOI: https://doi.org/10.1007/s00401-004-0863-x

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