Surgical outcome and treatment of thyrotropin (TSH)-secreting pituitary tumors in a tertiary referral center.

Abstract Objective Thyrotropin (TSH)-secreting pituitary tumors are rare and typically present with hyperthyroidism. Here we report the diagnosis, treatment and surgical outcomes in a series of patients with (TSH)-secreting pituitary tumors in a tertiary referral center. Methods Descriptive retrospective study that included all patients with thyrotropin (TSH)-secreting pituitary tumors who underwent transsphenoidal surgery in the Endocrinology and Nutrition Unit of the Virgen del Rocio University Hospital (Seville, Spain) between 2004 and 2016. Results The mean age at diagnosis was 37 42.8 ± 17 years. The mean time from onset of symptoms to diagnosis was 13±10 months. Four patients displayed symptoms indicating hyperthyroidism (one suffered from tachycardia); three patients showed symptoms due to mass effect (visual impairment and headache) and three patients were diagnosed based on incidental findings after routine blood tests (high fT4 levels). Eight patients had macroadenomas and two patients had microadenomas. Five patients underwent conventional pituitary surgery and five patients underwent expanded endoscopic transsphenoidal surgery. Six patients achieved cure after surgery. The other patients received radiotherapy and/or treatment with somatostatin analogues. Analysis of SSTR expression by immunohistochemistry could be performed in 6 tumors. Conclusions Our results confirm the clinical and hormonal heterogeneity caused by TSH-secreting pituitary adenomas. Surgery is considered the first choice of treatment for these tumors. We observed surgical cure rates similar to those reported in recent published series. SSTR2 and SSTR3 are highly expressed in TSH-secreting pituitary adenomas. Our results suggest that SSA treatment may be also helpful on the treatment of TSH-secreting pituitary adenomas.