| Abstract | Thyrotropin (TSH)-secreting adenomas are rare and, as most adenomas are large, invasive and difficult to cure by surgery only, many require additional medical treatment. Many TSH-secreting adenomas cosecrete growth hormone (GH) and/or prolactin (PRL). We evaluated the relationship between pathology and the effect of dopamine agonist bromocriptine and somatostatin analogue octreotide in 20 operated patients with TSH-secreting adenomas. The four men and 16 women ranged in age from 23 to 62 years; three had clinically overt acromegaly; two manifested galactorrhea-amenorrhea. Endocrinologically, elevated serum GH, and/or IGF-1 were observed in six patients and elevated serum PRL was observed in eight. Immunohistochemically, 16 of the 20 adenomas were positive for GH and/or PRL (GH-positive, n=13; PRL-positive, n=9). Pituitary-specific transcription factor Pit-1 was demonstrated in the nuclei of all adenoma cells. Octreotide tests showed suppression of serum TSH (<50%) in ten of 14 patients. Preoperative octreotide treatment effectively reduced serum TSH and tumor size in two patients. Electron micrographs of octreotide-treated TSH-secreting adenomas showed shrinkage of the cytoplasm and diffuse distribution of secretory granules. Our study suggests that cosecretion of GH and/or PRL from TSH-secreting adenoma has no correlation with response of tumor cells to medical treatment. |
| Authors | Akira Teramoto, Naoko Sanno, Shigeyuki Tahara, Yoshiyuki R Osamura
(Affiliation: Department of Neurosurgery, Nippon Medical School, 1-1-5 Sendagi Bunkyo-ku, 113-8603 Tokyo, Japan. a-tera at nms.ac.jp)
|
| Journal | Acta neuropathologica
(Acta Neuropathol)
Vol. 108
Issue 2
Pg. 147-53
(Aug 2004)
ISSN: 0001-6322 Germany |
| PMID | 15185102
(Publication Type: Comparative Study, Journal Article)
|
| Chemical References |
- Antineoplastic Agents, Hormonal
- Hormone Antagonists
- Bromocriptine
- Octreotide
- Prolactin
- Thyrotropin
- Growth Hormone
|
| Topics |
- Adenoma
(drug therapy, metabolism, pathology, ultrastructure)
- Adult
- Antineoplastic Agents, Hormonal
(therapeutic use)
- Bromocriptine
(therapeutic use)
- Female
- Growth Hormone
(blood)
- Hormone Antagonists
(therapeutic use)
- Humans
- Immunohistochemistry
(methods)
- Male
- Microscopy, Electron
(methods)
- Middle Aged
- Octreotide
(therapeutic use)
- Pituitary Neoplasms
(drug therapy, metabolism, pathology, ultrastructure)
- Prolactin
(blood)
- Retrospective Studies
- Staining and Labeling
- Thyrotropin
(metabolism)
|
