Abstract
TSH-secreting pituitary neuroendocrine tumor (PitNET) is one of the causes of central hyperthyroidism. The incidence of TSH PitNET is far lower than that of other PitNETs. The clinical manifestations of TSH PitNETs mainly include thyrotoxicosis or thyroid goiter, secretion disorders of other anterior pituitary hormones, and mass effect on the pituitary gland and its surrounding tissues. The application of high-sensitivity TSH detection methods contributes to the early diagnosis and timely treatment of TSH PitNETs. Improvements in magnetic resonance imaging (MRI) have advanced the noninvasive visualization of smaller PitNETs. Treatments for TSH PitNETs include surgery, drugs, and radiotherapy. This review focuses on the progress in pathogenesis, diagnosis, and treatment of TSH PitNETs to provide more information for the clinician.
Highlights
The authors thank the doctors, nurses, and postgraduate students of the Department of Endocrinology and Metabolism and Department of Pathology
This review focuses on the progress in pathogenesis, diagnosis, and treatment of TSH pituitary neuroendocrine tumor (PitNET) to provide more information for the clinician
For the functional TSH PitNETs, excessive TSH secretion leads to an increase in the synthesis and secretion of thyroid hormone by the thyroid, which leads to clinical manifestations of different degrees of thyrotoxicosis, including heat intolerance, hyperhidrosis, palpitations, emaciation, irritability, sleep disorders, and others
Summary
Pituitary neuroendocrine tumor (PitNET) is the most frequently intracranial tumor, and the occurrence seems to be similar despite geographic or ethnic differences [1]. Electron microscopy can show characteristic nuclear spheridia, secretory granules, increased RER amounts, a diffusely expanded and tortuous Golgi apparatus They express Pit-1, GATA-2/3, estrogen receptor-alpha (ER-a), a-SU, TSHb, GH, PRL, and/or CAM5.2 (± fibrous bodies) and usually do not have a consistent pattern of hormone expression. Electron microscopy can show tumor cells with numerous mature secretory granules, a predominantly spherical or ovoid nucleus, well-developed RER, and prominent Golgi apparatus [9]. They express Pit-1, ER-a, GATA-2/3, GH, PRL, TSHb, and/or a-subunit [12]. The diagnosis of TSH PitNETs requires a combination of clinical manifestations and signs, endocrine hormone measurements, functional tests, and imaging findings. It is noted that since the pathogenesis is not clear at present, an etiological diagnosis cannot be achieved yet
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