Tsh-staining pituitary adenomas: Rare, silent, and plurihoromonal

Carmen Polanco Santos, Zahrae Sandouk, Divya Yogi-Morren, Richard Prayson, Pablo Recinos, Laurence Kennedy, Amir Hamrahian, Kevin M. Pantalone

Research output: Contribution to journalArticle

Abstract

Objective: To characterize a single referral center experience with thyroid-stimulating hormone (TSH)staining adenomas. Methods: A retrospective chart review was conducted on histopathologic-proven TSH-staining adenomas resected between 2000-2015 at a single center. Tumors were classified as functional (hormonally active) or silent (hormonally inactive). Categorical variables were summarized using counts (n) and percentages; continuous variables were summarized using medians and ranges. Results: From the 1,065 pituitary adenomas operated, 32 (3.0%) showed diffuse staining for TSH. Median (range) age of patients was 49 years (20 to 77 years), and 21 (66%) were male. Tumor diameter was 20 mm (2 to 37 mm), with 7 (22%) microadenomas and 25 (78%) macroadenomas. Functional tumors (n = 5, 16%) had median diameter of 10 mm (5 to 21 mm) (2 microadenomas). At diagnosis, median (range) TSH was 4.3 μU/mL (1.2 to 6.9 μU/mL), and free thyroxine (FT4) was 2.4 ng/ dL (2.1 to 3.4 ng/dL). Three tumors stained for TSH alone, and 2 tumors costained with growth hormone (GH). No cavernous sinus invasion was seen, and 3 (60%) were considered cured after surgery. Silent tumors (n = 27, 84%) had median diameter of 20 mm (2 to 37 mm), with 5 (19%) microadenomas and 22 (81%) macroadenomas. Median (range) TSH was 1.2 μU/mL (0.48 to 4.6 μU/mL), and FT4 was 1.2 ng/dL (0.6 to 1.6). Only 2 (7.4%) tumors stained for TSH alone; the rest were plurihormonal, with GH being the most common. Cavernous sinus invasion was seen in 7 (27%) of the tumors, and 17 (63%) were considered surgically cured. Conclusion: In our series, 22% of TSH-staining adenomas were microadenomas, and 84% were silent. Most TSH-staining adenomas were plurihormonal, particularly costaining with GH.

Original languageEnglish (US)
Pages (from-to)580-588
Number of pages9
JournalEndocrine Practice
Volume24
Issue number6
DOIs
StatePublished - Jun 1 2018
Externally publishedYes

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Pituitary Neoplasms
Thyrotropin
Staining and Labeling
Adenoma
Neoplasms
Growth Hormone
Cavernous Sinus
Thyroxine
Referral and Consultation

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Santos, C. P., Sandouk, Z., Yogi-Morren, D., Prayson, R., Recinos, P., Kennedy, L., ... Pantalone, K. M. (2018). Tsh-staining pituitary adenomas: Rare, silent, and plurihoromonal. Endocrine Practice, 24(6), 580-588. https://doi.org/10.4158/EP-2018-0084

Tsh-staining pituitary adenomas : Rare, silent, and plurihoromonal. / Santos, Carmen Polanco; Sandouk, Zahrae; Yogi-Morren, Divya; Prayson, Richard; Recinos, Pablo; Kennedy, Laurence; Hamrahian, Amir; Pantalone, Kevin M.

In: Endocrine Practice, Vol. 24, No. 6, 01.06.2018, p. 580-588.

Research output: Contribution to journalArticle

Santos, CP, Sandouk, Z, Yogi-Morren, D, Prayson, R, Recinos, P, Kennedy, L, Hamrahian, A & Pantalone, KM 2018, 'Tsh-staining pituitary adenomas: Rare, silent, and plurihoromonal', Endocrine Practice, vol. 24, no. 6, pp. 580-588. https://doi.org/10.4158/EP-2018-0084
Santos CP, Sandouk Z, Yogi-Morren D, Prayson R, Recinos P, Kennedy L et al. Tsh-staining pituitary adenomas: Rare, silent, and plurihoromonal. Endocrine Practice. 2018 Jun 1;24(6):580-588. https://doi.org/10.4158/EP-2018-0084
Santos, Carmen Polanco ; Sandouk, Zahrae ; Yogi-Morren, Divya ; Prayson, Richard ; Recinos, Pablo ; Kennedy, Laurence ; Hamrahian, Amir ; Pantalone, Kevin M. / Tsh-staining pituitary adenomas : Rare, silent, and plurihoromonal. In: Endocrine Practice. 2018 ; Vol. 24, No. 6. pp. 580-588.
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abstract = "Objective: To characterize a single referral center experience with thyroid-stimulating hormone (TSH)staining adenomas. Methods: A retrospective chart review was conducted on histopathologic-proven TSH-staining adenomas resected between 2000-2015 at a single center. Tumors were classified as functional (hormonally active) or silent (hormonally inactive). Categorical variables were summarized using counts (n) and percentages; continuous variables were summarized using medians and ranges. Results: From the 1,065 pituitary adenomas operated, 32 (3.0{\%}) showed diffuse staining for TSH. Median (range) age of patients was 49 years (20 to 77 years), and 21 (66{\%}) were male. Tumor diameter was 20 mm (2 to 37 mm), with 7 (22{\%}) microadenomas and 25 (78{\%}) macroadenomas. Functional tumors (n = 5, 16{\%}) had median diameter of 10 mm (5 to 21 mm) (2 microadenomas). At diagnosis, median (range) TSH was 4.3 μU/mL (1.2 to 6.9 μU/mL), and free thyroxine (FT4) was 2.4 ng/ dL (2.1 to 3.4 ng/dL). Three tumors stained for TSH alone, and 2 tumors costained with growth hormone (GH). No cavernous sinus invasion was seen, and 3 (60{\%}) were considered cured after surgery. Silent tumors (n = 27, 84{\%}) had median diameter of 20 mm (2 to 37 mm), with 5 (19{\%}) microadenomas and 22 (81{\%}) macroadenomas. Median (range) TSH was 1.2 μU/mL (0.48 to 4.6 μU/mL), and FT4 was 1.2 ng/dL (0.6 to 1.6). Only 2 (7.4{\%}) tumors stained for TSH alone; the rest were plurihormonal, with GH being the most common. Cavernous sinus invasion was seen in 7 (27{\%}) of the tumors, and 17 (63{\%}) were considered surgically cured. Conclusion: In our series, 22{\%} of TSH-staining adenomas were microadenomas, and 84{\%} were silent. Most TSH-staining adenomas were plurihormonal, particularly costaining with GH.",
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AU - Prayson, Richard

AU - Recinos, Pablo

AU - Kennedy, Laurence

AU - Hamrahian, Amir

AU - Pantalone, Kevin M.

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N2 - Objective: To characterize a single referral center experience with thyroid-stimulating hormone (TSH)staining adenomas. Methods: A retrospective chart review was conducted on histopathologic-proven TSH-staining adenomas resected between 2000-2015 at a single center. Tumors were classified as functional (hormonally active) or silent (hormonally inactive). Categorical variables were summarized using counts (n) and percentages; continuous variables were summarized using medians and ranges. Results: From the 1,065 pituitary adenomas operated, 32 (3.0%) showed diffuse staining for TSH. Median (range) age of patients was 49 years (20 to 77 years), and 21 (66%) were male. Tumor diameter was 20 mm (2 to 37 mm), with 7 (22%) microadenomas and 25 (78%) macroadenomas. Functional tumors (n = 5, 16%) had median diameter of 10 mm (5 to 21 mm) (2 microadenomas). At diagnosis, median (range) TSH was 4.3 μU/mL (1.2 to 6.9 μU/mL), and free thyroxine (FT4) was 2.4 ng/ dL (2.1 to 3.4 ng/dL). Three tumors stained for TSH alone, and 2 tumors costained with growth hormone (GH). No cavernous sinus invasion was seen, and 3 (60%) were considered cured after surgery. Silent tumors (n = 27, 84%) had median diameter of 20 mm (2 to 37 mm), with 5 (19%) microadenomas and 22 (81%) macroadenomas. Median (range) TSH was 1.2 μU/mL (0.48 to 4.6 μU/mL), and FT4 was 1.2 ng/dL (0.6 to 1.6). Only 2 (7.4%) tumors stained for TSH alone; the rest were plurihormonal, with GH being the most common. Cavernous sinus invasion was seen in 7 (27%) of the tumors, and 17 (63%) were considered surgically cured. Conclusion: In our series, 22% of TSH-staining adenomas were microadenomas, and 84% were silent. Most TSH-staining adenomas were plurihormonal, particularly costaining with GH.

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