New elements in the diagnosis and treatment of thyrotropic pituitary adenomas with hyperthyroidism

Although thyrotropin-secreting pituitary tumors are rather exceptional, the authors have studied 5 new cases from 1982 to 1988. This apparently growing pattern is due to a more accurate diagnosis because of new laboratory measurements: --Immunoradiometric assay (IRMA) of ultra-sensitive thyrotropin (TSH); --Radioimmunoassay (RIA) of free alpha subunit of TSH; --Molar ratio of free alpha subunit/TSH before and after TRH stimulation; --Morphologic assessment of pituitary adenoma by computed tomographic scanning and nuclear magnetic resonance imaging; --Characterization of thyrotropin-secreting cells by immunohistochemical technics and identification of secretion products in cultured cells. The authors illustrate these new topics with a case report harboring a partial resistance to thyroid hormones. A 6-month treatment with somatostatin analogue (SMS 201.995) is reported, before transphenoidal ablation of the adenoma.