Pathologic and clinical features of pituitary adenomas showing TSH immunoreactivity.

Abstract

UNLABELLED:

Patients with thyrotropin-secreting pituitary adenomas may present with mass effect, hypopituitarism, and/or hyperthyroidism. The spectrum of pathologic and clinical features of patients whose tumors demonstrate β-thyrotropin immunoreactivity (β-TSH IR) has not been characterized. To characterize the phenotype of patients with pituitary adenomas with positive β-TSH IR, we conducted a retrospective analysis of patient records of all adult patients (n = 1,223) undergoing pituitary surgery in our institution over one decade (1999-2009). The search identified 166 adults with tumors which had β-TSH IR. These patients were individually matched to 166 patients whose tumors revealed no β-TSH IR. Clinical, pathological, imaging and biochemical data were extracted. 332 patients, aged 51.4 ± 15.1 years [150 women (45 %) and 182 men (55 %)], with pituitary adenomas (mean tumor diameter ± SD: 22.7 ± 9.0 mm) were studied. The degree of β-TSH IR was associated with the presence of central hyperthyroidism (p < 0.0001) or goiter (p = 0.0217). Patients whose tumors expressed more extensive β-TSH IR were less likely to develop pituitary apoplexy than those without β-TSH IR (p = 0.0428). In addition, the degree of β-TSH IR correlated with the presence of immunoreactivity for β-FSH (p < 0.0001), β-LH (p < 0.0001), alpha subunit (p < 0.0001), and GH (p = 0.0036).

CONCLUSIONS:

Pituitary adenomas expressing β-TSH IR were more likely to demonstrate immunoreactivity for β-FSH, β-LH, GH or alpha subunit. Patients with such tumors were more likely to exhibit hyperthyroidism and goiter, but less likely to develop pituitary apoplexy than patients without β-TSH IR. These findings suggest that β-TSH IR is associated with specific phenotypic features in patients with pituitary adenomas.

• Authors: Nicholas A Tritos, Samatha Eppakayala, Brooke Swearingen, E Tessa Hedley-Whyte, Karen K Miller, Lisa B Nachtigall, Steven K Grinspoon, Beverly M K Biller, Anne Klibanski
• Journal: Pituitary (Pituitary) Vol. 16 Issue 3 Pg. 287-93 (Sep 2013) ISSN: 1573-7403 [Electronic] United States
• PMID: 22869255 (Publication Type: Journal Article)

Chemical References

• Thyrotropin

Topics

• Adenoma (pathology)
• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Female
• Humans
• In Vitro Techniques
• Male
• Middle Aged
• Pituitary Neoplasms (pathology)
• Retrospective Studies
• Thyrotropin (metabolism)
• Young Adult