[TSH-secreting adenoma: Difficulty in management and review of literature-about one case]

TSH-secreting adenomas are rare; they represent less than 2 or 3% of all pituitary adenomas. We report a case of TSH-secreting adenoma in a 52 year old man revealed by cardiac arrythmia. The diagnosis was made in presence of hyperthyroidism with a TSH in the upper limit of normal value, with an increase in the alpha sub-unit and with the presence on the MRI of a pituitary macroadenoma. The patient was treated with somatostatin analogues before transphenoidal surgery. TSH-secreting adenomas are classically revealed by hyperthyroidisni with inappropriate secretion of TSH and a pituitary adenoma. Transphenoidal surgery is the recommended treatment but the results are not always satisfactory because most adenomas are invasive macroadenomas. Somatostatin analogues improve management and prognosis of these adenomas

traitement medical des adenomes hypophysaires

A medical treatment of adenoma of the pituitary gland has always existed. All the so called radical methods deal only with the tumour component of the disease and the risk seen in HIC.The correct treatment is that which is implemented before and after the radical act. It is often done for life, aiming at correcting the hormonal deficits which accompany these expensive processes. At present, beside this substitutive medical treatment progress has also been made in the fields of pathology and pharmacology of the disease. Thus, making available on the market a molecule of BRC and revolutionising the prolactin therapy. It must not be excluded that this discovery may in future exempt from such aggressive treatments as surgery and radiotherapy in other types of pituitary adenoma