Long action somatostatin analogues in patients with TSH-secreted pituitary adenomas: treatment experience
https://doi.org/10.14341/omet12768
Abstract
Thyrotoxicosis, which characteristics are increased excitability, emotional lability, tachycardia episodes, increasing of free fractions of tetraiodothyronine (T4) and triiodothyronine (T3) is one of the most common endocrinological syndromes. However, during the interpretation of thyroid status it is very important to take into account the possibility that a patient has TSH-secreting pituitary adenoma. Timely diagnosis of TSH-secreting adenomas plays prominent role in guiding the treatment course since it is associated with an improvement of long-term prognosis and an increase of the patient’s total life expectancy. Needed to underline that in some patients with TSH-secreting adenomas manifestations of the other pituitary hormones hypersecretion (first of all — somatotropin and prolactin) come to the fore, that lead to the development of acromegaly and hyperprolactinemia accordingly. Our work basing on two clinical cases presents main principles of diagnosis and specific clinical manifestations of TSH-secreting pituitary adenomas and demonstrates efficacy of somatostatin analogues in the treatment of this pathology.
About the Authors
L. K. DzeranovaRussian Federation
Larisa K. Dzeranova - MD, PhD; eLibrary SPIN: 2958-5555
Moscow
Competing Interests:
none
A. S. Shutova
Russian Federation
Aleksandra S. Shutova - MD, postgraduate student; eLibrary SPIN 4774-0114.
11 Dm. Ulyanova street, 117036 Moscow
Competing Interests:
none
E. A. Pigarova
Russian Federation
Ekaterina A. Pigarova - MD, PhD; eLibrary SPIN: 6912-6331
Moscow
Competing Interests:
none
P. A. Starostina
Polina A. Starostina; eLibrary SPIN: 5295-0536
Moscow
Competing Interests:
none
N. A. Khutsishvili
Russian Federation
Natalia A. Khutsishvili; eLibrary SPIN: 4320-0752
Moscow
Competing Interests:
none
S. Yu. Vorotnikova
Russian Federation
Svetlana Yu. Vorotnikova - MD; eLibrary SPIN: 6571-1206
Moscow
Competing Interests:
none
A. Yu. Grigoriev
Russian Federation
Andrei Yu. Grigoriev - MD, PhD; eLibrary SPIN 8910-8130
Moscow
Competing Interests:
none
O. V. Ivashchenko
Russian Federation
Oksana V. Ivashchenko - MD; eLibrary SPIN 7031-3273
Moscow
Competing Interests:
none
V. N. Azyan
Russian Federation
Vilen N. Azyan - MD, PhD; eLibrary SPIN: 7666-5950
Moscow
Competing Interests:
none
A. M. Lapshina
Russian Federation
Anastasia M. Lapshina - MD, PhD; eLibrary SPIN 1582-5033
Moscow
Competing Interests:
none
References
1. Beck-Peccoz P, Persani L. TSH-induced hyperthyroidism caused by a pituitary tumor. Nat Clin Pract Endocrinol Metab. 2006;2(9):524-528. doi: https://doi.org/10.1038/ncpendmet0276
2. Timmons JG, Mukhopadhyay B. Hyperthyroxinemia with a non-suppressed TSH: how to confidently reach a diagnosis in this clinical conundrum. Hormones (Athens). 2020;19(3):311-315. doi: https://doi.org/10.1007/s42000-020-00180-3
3. Kaldymova VA, Kiyaev AV, Tyulpakov AN. Syndromes of resistance to thyroid hormone. Clinical and experimental thyroidology. 2013;9(1):51-53. (In Russ.). doi: https://doi.org/10.14341/ket20139151-53
4. Beck-Peccoz P, Lania A, Beckers A, et al. 2013 European thyroid association guidelines for the diagnosis and treatment of thyrotropin-secreting pituitary tumors. Eur Thyroid J. 2013;2(2):76-82. doi: https://doi.org/10.1159/000351007
5. Singh BK, Yen PM. A clinician’s guide to understanding resistance to thyroid hormone due to receptor mutations in the TRalpha and TRbeta isoforms. Clin Diabetes Endocrinol. 2017;3:8. doi: https://doi.org/10.1186/s40842-017-0046-z
6. Yamada S, Fukuhara N, Horiguchi K, et al. Clinicopathological characteristics and therapeutic outcomes in thyrotropin-secreting pituitary adenomas: a single-center study of 90 cases. J Neurosurg. 2014;121(6):1462-1473. doi: https://doi.org/10.3171/2014.7.JNS1471
7. Jailer JW, Holub DA. Remission of Graves’ disease following radiotherapy of a pituitary neoplasm. Am J Med. 1960;28:497-500. doi: https://doi.org/10.1016/0002-9343(60)90181-9
8. De Herdt C, Philipse E, De Block C. Endocrine tumours: Thyrotropin-secreting pituitary adenoma: a structured review of 535 adult cases. Eur J Endocrinol. 2021;185(2):R65-R74. doi: https://doi.org/10.1530/EJE-21-0162
9. Luo P, Zhang L, Yang L, An Z, Tan H. Progress in the Pathogenesis, Diagnosis, and Treatment of TSH-Secreting Pituitary Neuroendocrine Tumor. Front Endocrinol (Lausanne). 2020;11. doi: https://doi.org/10.3389/fendo.2020.580264
10. Li X, Zhao B, Hou B, et al. Case Report and Literature Review: Ectopic Thyrotropin-Secreting Pituitary Adenoma in the Suprasellar Region. Front Endocrinol (Lausanne). 2021;12. doi: https://doi.org/10.3389/fendo.2021.619161
11. Mixson AJ, Friedman TC, Katz DA, et al. Thyrotropin-secreting pituitary carcinoma. J Clin Endocrinol Metab. 1993;76(2):529-533. doi: https://doi.org/10.1210/jcem.76.2.8432799
12. Beck-Peccoz P, Persani L, Lania A. Thyrotropin-Secreting Pituitary Adenomas. 2019. Eds. Feingold KR, Anawalt B, Boyce A, et al. Endotext [Internet]. South Dartmouth (MA): MDText. com, Inc.; 2000.
13. Cossu G, Daniel RT, Pierzchala K, et al. Thyrotropin-secreting pituitary adenomas: a systematic review and meta-analysis of postoperative outcomes and management. Pituitary. 2019;22(1):79-88. doi: https://doi.org/10.1007/s11102-018-0921-3
14. Gesundheit N, Petrick PA, Nissim M, et al. Thyrotropin-secreting pituitary adenomas: clinical and biochemical heterogeneity. Case reports and follow-up of nine patients. Ann Intern Med. 1989;111(10):827-835. doi: https://doi.org/10.7326/0003-4819-111-10-827
15. Fang HJ, Fu Y, Wu HW, et al. Short-term Preoperative Octreotide for Thyrotropin-secreting Pituitary Adenoma. Chin Med J (Engl). 2017;130(8):936-942. doi: https://doi.org/10.4103/0366-6999.204098
16. Gatto F, Barbieri F, Gatti M, et al. Balance between somatostatin and D2 receptor expression drives TSH-secreting adenoma response to somatostatin analogues and dopastatins. Clin Endocrinol (Oxf). 2012;76(3):407-414. doi: https://doi.org/10.1111/j.1365-2265.2011.04200.x
17. Yoshihara A, Isozaki O, Hizuka N, et al. Expression of type 5 somatostatin receptor in TSH-secreting pituitary adenomas: a possible marker for predicting long-term response to octreotide therapy. Endocr J. 2007;54(1):133-138. doi: https://doi.org/10.1507/endocrj.k06-133.
18. Yamakita N, Ikeda T, Murai T, et al. Thyrotropin-producing pituitary adenoma discovered as a pituitary incidentaloma. Intern Med. 1995;34(11):1055-1060. doi: https://doi.org/10.2169/internalmedicine.34.1055
19. Fu J, Wu A, Wang X, et al. Concurrent Graves’ Disease and TSH Secreting Pituitary Adenoma Presenting Suppressed Thyrotropin Levels: A Case Report and Review of the Literature. Front Endocrinol (Lausanne). 2020;11:523. doi: https://doi.org/10.3389/fendo.2020.00523
20. Beck-Peccoz P, Brucker-Davis F, Persani L, et al. Thyrotropin-secreting pituitary tumors. Endocr Rev. 1996;17(6):610-638. doi: https://doi.org/10.1210/edrv-17-6-610
21. Ohta S, Nishizawa S, Oki Y, et al. Coexistence of thyrotropin-producing pituitary adenoma with papillary adenocarcinoma of the thyroid--a case report and surgical strategy. Pituitary. 2001;4(4):271-274. doi: https://doi.org/10.1023/a:1020758716771
22. Beck-Peccoz P, Persani L, Lania A. Thyrotropin-Secreting Pituitary Adenomas. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext. South Dartmouth (MA); 2000.
23. Beck-Peccoz P, Persani L, Mannavola D, et al. Pituitary tumours: TSH-secreting adenomas. Best Pract Res Clin Endocrinol Metab. 2009;23(5):597-606. doi: https://doi.org/10.1016/j.beem.2009.05.006
24. Asteria C, Anagni M, Persani L, et al. Loss of heterozygosity of the MEN1 gene in a large series of TSH-secreting pituitary adenomas. J Endocrinol Invest. 2001;24(10):796-801. doi: https://doi.org/10.1007/BF03343929
25. Gessl A, Freissmuth M, Czech T, et al. Growth hormone-prolactin-thyrotropin-secreting pituitary adenoma in atypical McCune-Albright syndrome with functionally normal Gs alpha protein. J Clin Endocrinol Metab. 1994;79(4):1128-1134. doi: https://doi.org/10.1210/jcem.79.4.7962285
26. Beck-Peccoz P, Persani L. Thyrotropinomas. Endocrinol Metab Clin North Am. 2008;37(1):123-134. doi: https://doi.org/10.1016/j.ecl.2007.10.001
27. Chanson P. Octreotide Therapy for Thyroid-Stimulating Hormone-Secreting Pituitary Adenomas: A Follow-up of 52 Patients. Ann Intern Med. 1993;119(3):236. doi: https://doi.org/10.7326/0003-4819-119-3-199308010-00010
28. Socin H, Chanson P, Delemer B, et al. The changing spectrum of TSH-secreting pituitary adenomas: diagnosis and management in 43 patients. Eur J Endocrinol. 2003;148(4):433-442. doi: https://doi.org/10.1530/eje.0.1480433
29. Bertherat J, Brue T, Enjalbert A, et al. Somatostatin receptors on thyrotropin-secreting pituitary adenomas: comparison with the inhibitory effects of octreotide upon in vivo and in vitro hormonal secretions. J Clin Endocrinol Metab. 1992;75(2):540-546. doi: https://doi.org/10.1210/jcem.75.2.1353505
30. Brucker-Davis F, Oldfield EH, Skarulis MC, et al. Thyrotropin-Secreting Pituitary Tumors: Diagnostic Criteria, Thyroid Hormone Sensitivity, and Treatment Outcome in 25 Patients Followed at the National Institutes of Health. J Clin Endocrinol Metab. 1999;84(2):476-486. doi: https://doi.org/10.1210/jcem.84.2.5505
31. Beck-Peccoz P, Persani L. Thyrotropin-secreting pituitary adenomas. In: Thyroid Disease. Available from: www.thyroidmanager.org
32. Beck-Peccoz P, Persani L: TSH-producing adenomas. In Jameson JL, DeGroot LJ editors. Endocrinology, ed 5. Philadelphia: Saunders; 2010.
33. Shimatsu A, Nakamura A, Takahashi Y, et al. Preoperative and long-term efficacy and safety of lanreotide autogel in patients with thyrotropin-secreting pituitary adenoma: a multicenter, single-arm, phase 3 study in Japan. Endocr J. 2021;68(7):EJ20-0707. doi: https://doi.org/10.1507/endocrj.EJ20-0707
34. Kuhn JM, Arlot S, Lefebvre H, et al. Evaluation of the treatment of thyrotropin-secreting pituitary adenomas with a slow release formulation of the somatostatin analog lanreotide. J Clin Endocrinol Metab. 2000;85(4):1487-1491. doi: https://doi.org/10.1210/jcem.85.4.6548
35. Ito T, Fujimori N, Honma Y, et al. Long-term safety and efficacy of lanreotide autogel in Japanese patients with neuroendocrine tumors: Final results of a phase II open-label extension study. Asia Pac J Clin Oncol. 2021;17(5):e153-e161. doi: https://doi.org/10.1111/ajco.13371
Supplementary files
|
1. Figure 1. Free tetraiodothyronine level dynamics in the blood of patient N. | |
Subject | ||
Type | Research Instrument | |
View
(100KB)
|
Indexing metadata ▾ |
|
2. Figure 2. Free tetraiodothyronine level dynamics in the blood of patient Yu. | |
Subject | ||
Type | Research Instrument | |
View
(106KB)
|
Indexing metadata ▾ |
Review
For citations:
Dzeranova L.K., Shutova A.S., Pigarova E.A., Starostina P.A., Khutsishvili N.A., Vorotnikova S.Yu., Grigoriev A.Yu., Ivashchenko O.V., Azyan V.N., Lapshina A.M. Long action somatostatin analogues in patients with TSH-secreted pituitary adenomas: treatment experience. Obesity and metabolism. 2021;18(4):438-446. (In Russ.) https://doi.org/10.14341/omet12768

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0).