open access

Vol 67, No 5 (2016)
Original papers
Published online: 2016-07-12
Submitted: 2016-01-04
Accepted: 2016-02-05
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“Silent” thyrotropin (TSH) expression in acromegaly and clinically non-functioning pituitary adenomas

Marek Pawlikowski, Hanna Pisarek, Maria Jaranowska, Maciej Radek, Katarzyna Winczyk, Jolanta Kunert-Radek
DOI: 10.5603/EP.a2016.0056
·
Endokrynologia Polska 2016;67(5):515-518.

open access

Vol 67, No 5 (2016)
Original papers
Published online: 2016-07-12
Submitted: 2016-01-04
Accepted: 2016-02-05

Abstract

Introduction: The pituitary adenomas secreting thyrotropin (TSH) are considered the rarest type of hormonally active pituitary tumour. In spite of that, many cases are described in the literature. On the other hand, the observations of the co-expression of TSH with other pituitary hormones (mostly with growth hormone [GH]) and “silent” expression of TSH in clinically non-functioning pituitary adenomas (CNFPA) are rather scarce.

Material and methods: Among 93 examined pituitary adenomas, 22 of them were diagnosed as active acromegaly and 71 as clinically non-functioning pituitary adenomas (CNFPA). All of them were immunostained with antibodies against pituitary hormones, including the anti-TSH antibody. TSH-immunopositive adenomas are immunostained also to detect somatostatin receptor subtypes (SSTR 1-5).

Results: TSH immunopositivity was found in 4.2% of CNFPA (3/71 tumours) and in 13.6% (3/22) cases of somatotropinomas manifesting as active acromegaly. All of the examined TSH-immunopositive adenomas expressed SSTR subtypes except SSTR4. The symptoms of hyperthyroidism were not observed in any of the acromegalic patients co-expressing TSH with GH.

Conclusions: Our data confirm the relative rarity of TSH expression or co-expression of TSH in pituitary tumours. In most cases TSH is co-expressed with GH in patients with acromegaly and is not accompanied by hyperthyroidism. The “silent” expression of TSH may occur also, although rarely in CNFPA. The strong expression of SSTR in TSH-immunopositive CNFPA (“silent thyrotropinoma”) indicates the possibility of the treatment of these tumours with somatostatin analogues. (Endokrynol Pol 2016; 67 (5): 515–518)

Abstract

Introduction: The pituitary adenomas secreting thyrotropin (TSH) are considered the rarest type of hormonally active pituitary tumour. In spite of that, many cases are described in the literature. On the other hand, the observations of the co-expression of TSH with other pituitary hormones (mostly with growth hormone [GH]) and “silent” expression of TSH in clinically non-functioning pituitary adenomas (CNFPA) are rather scarce.

Material and methods: Among 93 examined pituitary adenomas, 22 of them were diagnosed as active acromegaly and 71 as clinically non-functioning pituitary adenomas (CNFPA). All of them were immunostained with antibodies against pituitary hormones, including the anti-TSH antibody. TSH-immunopositive adenomas are immunostained also to detect somatostatin receptor subtypes (SSTR 1-5).

Results: TSH immunopositivity was found in 4.2% of CNFPA (3/71 tumours) and in 13.6% (3/22) cases of somatotropinomas manifesting as active acromegaly. All of the examined TSH-immunopositive adenomas expressed SSTR subtypes except SSTR4. The symptoms of hyperthyroidism were not observed in any of the acromegalic patients co-expressing TSH with GH.

Conclusions: Our data confirm the relative rarity of TSH expression or co-expression of TSH in pituitary tumours. In most cases TSH is co-expressed with GH in patients with acromegaly and is not accompanied by hyperthyroidism. The “silent” expression of TSH may occur also, although rarely in CNFPA. The strong expression of SSTR in TSH-immunopositive CNFPA (“silent thyrotropinoma”) indicates the possibility of the treatment of these tumours with somatostatin analogues. (Endokrynol Pol 2016; 67 (5): 515–518)

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Keywords

acromegaly; clinically nonfunctioning pituitary adenomas; silent thyrotropinoma

About this article
Title

“Silent” thyrotropin (TSH) expression in acromegaly and clinically non-functioning pituitary adenomas

Journal

Endokrynologia Polska

Issue

Vol 67, No 5 (2016)

Pages

515-518

Published online

2016-07-12

DOI

10.5603/EP.a2016.0056

Bibliographic record

Endokrynologia Polska 2016;67(5):515-518.

Keywords

acromegaly
clinically nonfunctioning pituitary adenomas
silent thyrotropinoma

Authors

Marek Pawlikowski
Hanna Pisarek
Maria Jaranowska
Maciej Radek
Katarzyna Winczyk
Jolanta Kunert-Radek

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