Case Report and Literature Review: Ectopic Thyrotropin-Secreting Pituitary Adenoma in the Suprasellar Region

Overview

Journal Front Endocrinol (Lausanne)

Specialty Endocrinology

Date 2021 Mar 29

PMID 33776916

Citations 6

Authors

Xiaoxu Li

Binghao Zhao

Bo Hou

Jing Wang

Jianyu Zhu

Yong Yao

Xiaolan Lian

Affiliations

Soon will be listed here.

Abstract

Ectopic thyrotropin-secreting pituitary adenoma (ectopic TSH-oma) is a rare disorder that is easily misdiagnosed in clinical work. We report one patient who presented with hyperthyroidism and a suprasellar mass. In this case, preoperative diagnosis of suprasellar ectopic thyrotropin-secreting pituitary adenoma was challenging. A literature review revealed that a total of 11 patients with ectopic TSH-oma were previously reported, and only our one case was diagnosed in the microadenoma stage. Most of the patients with TSH-oma or ectopic TSH-oma were middle-aged. We described ectopic TSH-oma in a child at length. We recommend that ectopic TSH-oma should be considered in the differential diagnosis of thyrotoxicosis syndrome to achieve an accurate, early diagnosis. The somatostatin suppression test and imaging examinations, such as magnetic resonance imaging and positron emission tomography/magnetic resonance imaging, could contribute to the diagnosis. Once the diagnosis was highly suspected, tumor resection could achieve a satisfying long-term outcome in ectopic TSH-oma.

Citing Articles

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Ectopic Thyrotropin-Secreting Tumor in the Nasopharynx Causing Central Hyperthyroidism.

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Zhu C, Liu T, Yu H, Chang L, Zhang X, Yao J Front Endocrinol (Lausanne). 2024; 15:1301260.

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Combination of transsphenoidal endoscopic surgery and presurgical somatostatin analogs in thyrotropin (TSH)-secreting pituitary adenomas: Treatment outcome and long-term remission at a single pituitary center.

Liu J, Yang Y, Duan L, Chai X, Zhu H, Deng K Front Endocrinol (Lausanne). 2022; 13:1061029.

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References

Pasquini E, Faustini-Fustini M, Sciarretta V, Saggese D, Roncaroli F, Serra D . Ectopic TSH-secreting pituitary adenoma of the vomerosphenoidal junction. Eur J Endocrinol. 2003; 148(2):253-7. DOI: 10.1530/eje.0.1480253. View

Famini P, Maya M, Melmed S . Pituitary magnetic resonance imaging for sellar and parasellar masses: ten-year experience in 2598 patients. J Clin Endocrinol Metab. 2011; 96(6):1633-41. PMC: 3100749. DOI: 10.1210/jc.2011-0168. View

Beck-Peccoz P, Giavoli C, Lania A . A 2019 update on TSH-secreting pituitary adenomas. J Endocrinol Invest. 2019; 42(12):1401-1406. DOI: 10.1007/s40618-019-01066-x. View

Seltzer J, Lucas J, Commins D, Lerner O, Lerner A, Carmichael J . Ectopic ACTH-secreting pituitary adenoma of the sphenoid sinus: case report of endoscopic endonasal resection and systematic review of the literature. Neurosurg Focus. 2015; 38(2):E10. DOI: 10.3171/2014.10.FOCUS14685. View

Melmed S . Pituitary-Tumor Endocrinopathies. N Engl J Med. 2020; 382(10):937-950. DOI: 10.1056/NEJMra1810772. View

Tjornstrand A, Filipsson Nystrom H . DIAGNOSIS OF ENDOCRINE DISEASE: Diagnostic approach to TSH-producing pituitary adenoma. Eur J Endocrinol. 2017; 177(4):R183-R197. DOI: 10.1530/EJE-16-1029. View

Beck-Peccoz P, Lania A, Beckers A, Chatterjee K, Wemeau J . 2013 European thyroid association guidelines for the diagnosis and treatment of thyrotropin-secreting pituitary tumors. Eur Thyroid J. 2014; 2(2):76-82. PMC: 3821512. DOI: 10.1159/000351007. View

Zhao X, Xiao J, Xing B, Wang R, Zhu Z, Li F . Comparison of (68)Ga DOTATATE to 18F-FDG uptake is useful in the differentiation of residual or recurrent pituitary adenoma from the remaining pituitary tissue after transsphenoidal adenomectomy. Clin Nucl Med. 2014; 39(7):605-8. DOI: 10.1097/RLU.0000000000000457. View

Gittleman H, Ostrom Q, Farah P, Ondracek A, Chen Y, Wolinsky Y . Descriptive epidemiology of pituitary tumors in the United States, 2004-2009. J Neurosurg. 2014; 121(3):527-35. DOI: 10.3171/2014.5.JNS131819. View

10.

Hanaoka Y, Ogiwara T, Kakizawa Y, Nagm A, Seguchi T, Aoyama T . Calcified ectopic TSH-secreting pituitary adenoma mimicking craniopharyngioma: a rare case report and literature review. Acta Neurochir (Wien). 2018; 160(10):2001-2005. DOI: 10.1007/s00701-018-3638-1. View

11.

Fujio S, Ashari , Habu M, Yamahata H, Moinuddin F, Bohara M . Thyroid storm induced by TSH-secreting pituitary adenoma: a case report. Endocr J. 2014; 61(11):1131-6. DOI: 10.1507/endocrj.ej14-0278. View

12.

Mojtahedi A, Thamake S, Tworowska I, Ranganathan D, Delpassand E . The value of (68)Ga-DOTATATE PET/CT in diagnosis and management of neuroendocrine tumors compared to current FDA approved imaging modalities: a review of literature. Am J Nucl Med Mol Imaging. 2014; 4(5):426-34. PMC: 4138137. View

13.

Agely A, Okromelidze L, Vilanilam G, Chaichana K, Middlebrooks E, Gupta V . Ectopic pituitary adenomas: common presentations of a rare entity. Pituitary. 2019; 22(4):339-343. DOI: 10.1007/s11102-019-00954-y. View

14.

Yang B, Chong V, Wang Z, Xian J, Chen Q . Sphenoid sinus ectopic pituitary adenomas: CT and MRI findings. Br J Radiol. 2009; 83(987):218-24. PMC: 3473558. DOI: 10.1259/bjr/76663418. View

15.

Yu B, Zhang Z, Song H, Chi Y, Shi C, Xu M . Clinical Importance of Somatostatin Receptor 2 (SSTR2) and Somatostatin Receptor 5 (SSTR5) Expression in Thyrotropin-Producing Pituitary Adenoma (TSHoma). Med Sci Monit. 2017; 23:1947-1955. PMC: 5411020. DOI: 10.12659/msm.903377. View

16.

Amlashi F, Tritos N . Thyrotropin-secreting pituitary adenomas: epidemiology, diagnosis, and management. Endocrine. 2016; 52(3):427-40. DOI: 10.1007/s12020-016-0863-3. View

17.

Collie R, Collie M . Extracranial thyroid-stimulating hormone-secreting ectopic pituitary adenoma of the nasopharynx. Otolaryngol Head Neck Surg. 2005; 133(3):453-4. DOI: 10.1016/j.otohns.2004.10.015. View

18.

Zhu J, Lu L, Yao Y, Chen S, Li W, You H . Long-term follow-up for ectopic ACTH-secreting pituitary adenoma in a single tertiary medical center and a literature review. Pituitary. 2019; 23(2):149-159. DOI: 10.1007/s11102-019-01017-y. View

19.

Song M, Wang H, Song L, Tian H, Ge Q, Li J . Ectopic TSH-secreting pituitary tumor: a case report and review of prior cases. BMC Cancer. 2014; 14:544. PMC: 4125694. DOI: 10.1186/1471-2407-14-544. View

20.

Sriphrapradang C, Srichomkwun P, Refetoff S, Mamanasiri S . A Novel Thyroid Hormone Receptor Beta Gene Mutation (G251V) in a Thai Patient with Resistance to Thyroid Hormone Coexisting with Pituitary Incidentaloma. Thyroid. 2016; 26(12):1804-1806. PMC: 5175442. DOI: 10.1089/thy.2016.0450. View