Diagnosis, pathology, and management of TSH-secreting pituitary tumors. A single-center retrospective study of 20 patients from 1981 to 2014
Autor: | Alexandre Vasiljevic, Gérald Raverot, Véronique Raverot, Françoise Borson-Chazot, Hélène Lasolle, Celine Gaillard, Oana-Maria Capraru, Emmanuel Jouanneau, Jacqueline Trouillas |
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Přispěvatelé: | Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS) |
Rok vydání: | 2019 |
Předmět: |
Adenoma
Adult Male endocrine system medicine.medical_specialty endocrine system diseases Endocrinology Diabetes and Metabolism medicine.medical_treatment [SDV]Life Sciences [q-bio] Thyrotropin 030209 endocrinology & metabolism Single Center Gastroenterology History 21st Century Hyperthyroidism 03 medical and health sciences 0302 clinical medicine Endocrinology Internal medicine medicine Humans Pituitary Neoplasms Aged Retrospective Studies Transsphenoidal surgery business.industry Somatostatin receptor Pituitary tumors Retrospective cohort study General Medicine History 20th Century Middle Aged medicine.disease Prolactin 3. Good health Radiation therapy Somatostatin 030220 oncology & carcinogenesis Female France business hormones hormone substitutes and hormone antagonists |
Zdroj: | Annales d'Endocrinologie Annales d'Endocrinologie, Elsevier Masson, 2019, 80, pp.216-224. ⟨10.1016/j.ando.2019.06.006⟩ |
ISSN: | 2213-3941 0003-4266 |
Popis: | TSH (thyroid-stimulating hormone)-secreting tumors are the rarest type of pituitary tumor. The objective of this study was to describe initial presentation and follow-up in patients presenting TSH-secreting tumors and to characterize the pathological features, based on a cohort of 20 patients treated in our referral center, between 1981 and 2014. Most of the patients (75%) were female, aged around 50 years (mean: 50 ± 13 years). Initial symptoms were hyperthyroidism (8/20) and/or tumor mass-related symptoms. Median time to diagnosis was 18 months. Biochemical hyperthyroidism was found in 15 patients. Most of the tumors were macroadenomas (75%) and 30% were invasive. Seventeen patients underwent transsphenoidal surgery. All tumors expressed TSH, with > 50% positive cells. Eleven were monohormonal and 6 plurihormonal, expressing βTSH plus growth hormone (GH) and/or prolactin (PRL). Both subtypes showed high expression of Pit-1 and SSTR2A somatostatin receptors. SSTR5 was slightly expressed in the plurihormonal subtype. Ki-67 index was elevated (≥ 3%) in only one tumor. Signs of hyperthyroidism were more frequent in the plurihormonal than in the monohormonal subtype. At final follow-up (median: 34.79 ± 66.7 months), 75% of the patients were in complete remission after surgery; persistent hyperthyroidism was controlled by somatostatin analogs, alone (n = 3) or associated to radiotherapy (n = 1). The multidisciplinary approach promoted early diagnosis and control of hyperthyroidism by neurosurgical treatment, associated to somatostatin analogs or not. Clinical/pathological correlations highlighted the variations in immune profiles and in clinical and biological symptoms. |
Databáze: | OpenAIRE |
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