Pituitary macroadenoma secreting thyrotropin and growth hormone: remission of bihormonal hypersecretion in response to lanreotide therapy.

We report a case of mixed TSH- and GH-secreting pituitary adenoma in a 60-year-old female patient. She presented with bitemporal hemianopsia and large invasive pituitary macroadenoma. Blood hormone levels determinations revealed elevated thyroid hormones, TSH, and IGF-1 with a relatively low GH. The patient had a mild acromegalic appearance but did not display signs of thyrotoxicosis or goiter. She underwent two pituitary surgical procedures followed by radiotherapy, but despite treatment was still hormonally active. Pathological examination of the resected tumor immunostained positively for both TSH and GH. The patient was subsequently treated with injections of lanreotide, a depot long-acting somatostatin analog, resulting in suppression of blood TSH, thyroid hormones, alpha-subunits, GH and IGF-1.