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Journal of Clinical Endocrinology & Metabolism Vol. 72, No. 2 477-483
doi:10.1210/jcem-72-2-477
Copyright © 1991 by the Endocrine Society.
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*METHIMAZOLE

Thyrotropin-Secreting Pituitary Adenomas: Report of Seven Cases

ALBERT BECKERS, ROGER ABS, CHARLES MAHLER, JEAN-LOUIS VANDALEM*, GUY PIRENS, GEORGES HENNEN and ACHILLE STEVENAERT

Departments of Endocrinology (A.B., J-L.V., G.P., G.H.) and Neurosurgery (A.S.), University of Liège Liège;, Belgium
The Department of Endocrinology, University of Antwerp (R.A.), and Middelheim Hospital of Antwerp (CM.) Antwerp, Belgium

Address all correspondence and requests for reprints to: Albert Beckers, M.D., Ph.D., Department of Endocrinology, University of Liege, CHU-B35, B-4000 Liege, Belgium.

Seven patients with hyperthyroidism due to a TSH-secreting pituitary macroadenoma have been observed of a total of 800 patients with pituitary tumors over a period of 15 yr. Serum TSH levels varied between 1.1-36.3 mU/L. The serum {alpha}-subunit level was low in 1 case, while in 4 other cases the concentration was elevated and varied between 3.7–7.8 µg/L. Serum TSH/3 levels were normal in the 4 cases in which it was determined. Serum GH or PRL levels were elevated in 5 cases. In 1 patient the cosecretion of TSH, GH, and PRL was confirmed by immunocytochemical examination. Serum TSH and {alpha}-subunit responses to TRH, GnRH, CRF, GRF, dexamethasone, methimazole, T3, and bromocriptine administration were variable when studied. Serum TSH and {alpha}-subunit circadian rhythms were absent in 1 case and inverted in another. A serum {alpha}-subunit pulsatility without TSH pulses was observed in 1 patient. Five patients underwent transsphenoidal adenomectomy. Three of 4 patients operated on in our center were cured, but a recurrence of the adenoma was found in 1 of them after 5 yr. The fifth patient was not cured. Treatment with octreotide in 3 patients resulted in normalization of serum TSH, GH, and thyroid hormones levels. Cosecretion of PRL in 1 case and asubunit in 2 cases was also inhibited. Partial tachyphylaxis occurred in 1 patient. In summary, heterogeneity in clinical presentation, hormonal expression, and therapeutic response appears to characterize these TSH-secreting adenomas.

* Deceased.

Received June 8, 1990.




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