Akira Taguchi1, Yasuyuki Kinoshita2, Fumiyuki Yamasaki2, Kazunori Arita3, Atsushi Tominaga4. 1. Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minamiku, Hiroshima, 734-8551, Japan. akira.taguch.0929@gmail.com. 2. Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minamiku, Hiroshima, 734-8551, Japan. 3. Department of Neurosurgery, Izumi Regional Medical Center, Izumi, Japan. 4. Department of Neurosurgery and Neuro-Endovascular Therapy, Hiroshima Prefectural Hospital, Hiroshima, Japan.
Abstract
PURPOSE: Thyrotropin-secreting pituitary adenomas (TSPA) are extremely rare pituitary adenomas; their perioperative thyroid hormone dynamics have not been completely elucidated. Here, we investigated the clinical characteristics, perioperative findings, and thyroid hormone dynamics of TSPA at a single institution. METHODS: We enrolled 11 patients who underwent transsphenoidal surgery (TSS) for TSPA during 2005-2019 at Hiroshima University Hospital (TSPA group) and 24 patients who underwent TSS for nonfunctioning pituitary adenomas (NFPA) in 2019 (NFPA group; for comparison). Their clinical characteristics, operative findings, and thyroid hormone dynamics, including serum thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4), were retrospectively analyzed. RESULTS: The NFPA group demonstrated a slight temporary decrease in serum TSH/ FT3/ FT4 levels on day 1 postoperatively and improvement in the levels on day 4 postoperatively. In contrast, the serum TSH level in the TSPA group demonstrated a marked decrease on day 1 postoperatively but improved on day 7 postoperatively. The serum FT3 level was also markedly decreased on day 1 postoperatively but remained within the normal range. The serum FT4 level revealed a gradual decrease until day 21 postoperatively and then recovered within the normal range 3 months postoperatively. There was no significant difference in the frequency of decline in serum FT4 level between the two groups; no patients required thyroid hormonal replacement 3 months postoperatively. CONCLUSIONS: Despite a variable degree of transient hypothyroidism, all patients had a normal thyroid function after 3 months follow-up.
PURPOSE: Thyrotropin-secreting pituitary adenomas (TSPA) are extremely rare pituitary adenomas; their perioperative thyroid hormone dynamics have not been completely elucidated. Here, we investigated the clinical characteristics, perioperative findings, and thyroid hormone dynamics of TSPA at a single institution. METHODS: We enrolled 11 patients who underwent transsphenoidal surgery (TSS) for TSPA during 2005-2019 at Hiroshima University Hospital (TSPA group) and 24 patients who underwent TSS for nonfunctioning pituitary adenomas (NFPA) in 2019 (NFPA group; for comparison). Their clinical characteristics, operative findings, and thyroid hormone dynamics, including serum thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4), were retrospectively analyzed. RESULTS: The NFPA group demonstrated a slight temporary decrease in serum TSH/ FT3/ FT4 levels on day 1 postoperatively and improvement in the levels on day 4 postoperatively. In contrast, the serum TSH level in the TSPA group demonstrated a marked decrease on day 1 postoperatively but improved on day 7 postoperatively. The serum FT3 level was also markedly decreased on day 1 postoperatively but remained within the normal range. The serum FT4 level revealed a gradual decrease until day 21 postoperatively and then recovered within the normal range 3 months postoperatively. There was no significant difference in the frequency of decline in serum FT4 level between the two groups; no patients required thyroid hormonal replacement 3 months postoperatively. CONCLUSIONS: Despite a variable degree of transient hypothyroidism, all patients had a normal thyroid function after 3 months follow-up.
Authors: Axel Tjörnstrand; Kerstin Gunnarsson; Max Evert; Erik Holmberg; Oskar Ragnarsson; Thord Rosén; Helena Filipsson Nyström Journal: Eur J Endocrinol Date: 2014-08-01 Impact factor: 6.664
Authors: E Macchia; M Gasperi; M Lombardi; L Morselli; A Pinchera; G Acerbi; G Rossi; E Martino Journal: J Endocrinol Invest Date: 2009-10 Impact factor: 4.256
Authors: Ferdinand Roelfsema; Nienke R Biermasz; Marijke Frolich; Daniel M Keenan; Johannes D Veldhuis; Johannes A Romijn Journal: J Clin Endocrinol Metab Date: 2009-03-31 Impact factor: 5.958
Authors: H Valdes Socin; P Chanson; B Delemer; A Tabarin; V Rohmer; J Mockel; A Stevenaert; A Beckers Journal: Eur J Endocrinol Date: 2003-04 Impact factor: 6.664