Diagnosis and treatment strategies of pituitary thyroid stimulating hormone adenomas
10.11855/j.issn.0577-7402.0252.2024.0919
- VernacularTitle:垂体促甲状腺激素腺瘤的诊疗策略
- Author:
Hao YU
1
;
Bei GUO
;
Jing PEI
;
Hui-Xin TONG
;
Yu-Jie LI
;
Lin-Lang LIANG
Author Information
1. 北部战区总医院内分泌科,辽宁 沈阳 110016
- Keywords:
pituitary thyroid-stimulating hormone adenomas;
resistance to thyroid hormone;
thyrotoxicosis;
diagnosis;
treatment
- From:
Medical Journal of Chinese People's Liberation Army
2024;49(11):1251-1258
- CountryChina
- Language:Chinese
-
Abstract:
Pituitary thyroid-stimulating hormone(TSH)adenomas is a rare pituitary disorder,accounting for less than 2%of pituitary adenomas.The clinical manifestations primarily include mild to moderate symptoms of hyperthyroidism,corresponding symptoms caused by other anterior pituitary hormone secretion disorders,and symptoms resulting from the mass effect of pituitary tumors.Pituitary TSH adenomas need to be differentiated from primary hyperthyroidism(Graves'disease)and resistance to thyroid hormone(RTH),as misdiagnosis can lead to tumor growth and aggravation of the condition.Currently,with the help of sensitive laboratory tests,imaging examinations,and targeted functional tests,pituitary TSH adenomas can be diagnosed relatively accurately.The preferred treatment is surgical resection.In cases where surgery is not feasible or unsuccessful,radiotherapy or medical therapy can be considered.Long-acting somatostatin analogs can effectively reduce tumor volume and decrease TSH secretion,thereby normalizing free 3,5,3',5'-tetraiodothyronine(FT4)and free 3,5,3'-triiodothyronine(FT3).Early identification and effective treatment are significant for patients with pituitary TSH adenomas.This review summarizes the epidemiology,pathological characteristics,screening objects,clinical manifestations,auxiliary examinations,diagnosis and treatment,follow-up and evaluation of pituitary TSH adenoma,aiming to provide guidance for the clinical diagnosis and treatment of this condition.
