Successful management of octreotide-insensitive thyrotropin-secreting pituitary adenoma with bromocriptine and surgery: A case report and literature review: Erratum
نویسندگان
چکیده
RATIONALE Case reports concerning the value of dopamine agonists in the treatment of patients with thyrotropin-secreting pituitary adenoma (TSHoma) are limited. Herein, we present a rare case of octreotide-insensitive TSHoma responding to bromocriptine therapy. PATIENT CONCERNS A 45-year-old Chinese man was admitted to Peking Union Medical College Hospital with marked clinical manifestations of hyperthyroidism. DIAGNOSES Thyroid function tests demonstrated elevated concentrations of free thyroid hormones in the presence of normal thyrotropin. Magnetic resonance imaging findings showed a pituitary microadenoma on the right side of the sellar region. Based on characteristic endocrine results and neuroimaging findings, the patient was diagnosed with TSHoma. INTERVENTIONS Most patients with TSHomas are significantly responsive to somatostatin analog treatment. However, our patient was orally administered with bromocriptine to normalize thyroid function as assessed by suppression tests conducted prior to surgery. A transsphenoidal surgery was performed by an experienced neurosurgeon for tumor removal. OUTCOMES The pituitary lesion was totally resected. Following the operation, the results of thyroid function tests were immediately within reference limits. During the follow-up, there was no residual or recurrent tumor. LESSONS Attention should be paid to the role of dopamine agonists such as bromocriptine and cabergoline as adjuvant therapy for TSHomas that are insensitive to traditional medical treatment by somatostatin analogs.
منابع مشابه
Coexisting Pituitary Adenoma and Suprasellar Meningioma: A Coincidence or Causation Effect? Report of Two Cases and Review of Literature
Background and Importance: The coexistence of pituitary adenoma and another type of brain tumor is a very rare clinical scenario. Even though such a presentation can be an incidental event but the possible pathogenesis of coexistence of different lesions in the sella and suprasellar region has not yet been elucidated. Case Presentation: Two cases of concomitant sellar and suprasellar region ...
متن کاملTSH-Secreting Pituitary Adenoma: Current Management and Review.
The neurosurgical literature contains little information about the current management of patients with thyroid-stimulating hormone (TSH)-secreting pituitary adenomas or about the usefulness of the somatostatin analogue octreotide in such cases. While TSH-secreting pituitary adenomas are rare, our review and illustrative case demonstrate the effectiveness of pretreating patients with octreotide ...
متن کاملShrinkage of thyrotrophin secreting pituitary adenoma treated with octreotide.
Thyrotrophin secreting pituitary adenomas are a rare cause of recurrent thyrotoxicosis. We report on a 47 year old woman with an 8-year history of this condition. In this case the somatostatin analogue, octreotide, normalized thyroid hormone levels. It was associated with marked tumour shrinkage, with striking reduction of the suprasellar extension and improved appearances in the region of the ...
متن کاملNEUROENDOCRINE CLINICAL CENTER BULLETIN Thyrotropin-secreting Pituitary Adenomas: Pitfalls in Diagnosis and Management
(SHBG): 73 nmol/l (normal, 13 to 71). His serum testosterone and the cortisol response on cosyntropin stimulation testing were normal. A presumptive diagnosis of a thyrotropin and growth hormone co-secreting pituitary adenoma was made. Octreotide LAR therapy was advised preoperatively to control thyroid hormone excess. He underwent transsphenoidal resection of the sellar mass, which was consist...
متن کاملTSH-secreting pituitary adenoma: benefits of pre-operative octreotide
UNLABELLED TSH-secreting pituitary adenomas are rare and the optimal investigation and management is uncertain. We describe a case of a 43 year-old woman with a TSH-secreting pituitary adenoma, highlighting diagnostic testing and our use, pre-operatively of somatostatin analogue therapy, which induced biochemical euthyroidism and a reduction in tumour size. LEARNING POINTS The differential di...
متن کامل