scholarly journals Immediate postoperative measurement of thyroid-stimulating hormone as an early predictor of remission in thyroid-stimulating hormone–secreting pituitary adenomas

2020 ◽  
pp. 1-7
Author(s):  
Soo Heon Kim ◽  
Cheol Ryong Ku ◽  
Minkyun Na ◽  
Jihwan Yoo ◽  
Woohyun Kim ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Tumor Size ◽  
Thyroid Stimulating Hormone ◽  
Early Postoperative Period ◽  
En Bloc ◽  
Rare Type ◽  
Csf Rhinorrhea ◽  
Extracapsular Dissection ◽  
Stimulating Hormone

OBJECTIVEThyroid-stimulating hormone (TSH)–secreting pituitary adenoma (TSHoma) is a rare type of pituitary adenoma; thus, little is known about TSHomas. The purpose of this study was to analyze clinical characteristics and therapeutic outcomes of TSHomas based on a single-center experience. The authors also searched for reliable preoperative and early postoperative factors that could predict long-term endocrinological remission.METHODSThe clinical, radiological, and pathological characteristics and surgical and endocrinological outcomes of 31 consecutive cases of TSHomas that were surgically treated between 2005 and 2017 were reviewed retrospectively. Preoperative factors were evaluated for their ability to predict long-term remission by comparing remission and nonremission groups. TSH and free thyroxine levels were measured at 2, 6, 12, 18, and 24 hours after surgery to determine whether they could predict long-term remission.RESULTSGross-total removal of tumor was achieved in 28 patients (90.3%), and 26 patients (83.9%) achieved endocrinological remission by surgery alone based on long-term endocrinological follow-up (median 50 months, range 32–81 months). The majority of the tumors were solid (21/31, 67.7%), and en bloc resection was possible in 16 patients (51.6%). Larger tumor size and tumor invasion into cavernous sinus and sphenoid sinus were strong predictors of lower rates of endocrinological remission. Immediate postoperative TSH level at 12 hours after surgery was the strongest predictor, with a 0.62 μIU/mL cutoff. Postoperative complications included CSF rhinorrhea in one patient and epistaxis in another patient, who underwent additional surgical treatment for the complications.CONCLUSIONSTumor size and extent are major prognostic factors for both extent of resection and endocrinological remission. The consistency of TSHomas was more likely to be solid, which makes extracapsular dissection more feasible. Long-term remission of TSHomas could be predicted even during the early postoperative period.

Elevations in Thyroid-Stimulating Hormone in Normal Subjects after Receiving Short-Term Lithium Carbonate

1988 ◽  
Vol 22 (3) ◽  
pp. 202-204 ◽  
Author(s):  
Merlin V. Nelson ◽  
Vickie Tutag-Lehr ◽  
R. Lee Evans
Keyword(s):  
Lithium Carbonate ◽  
Normal Subjects ◽  
Thyroid Stimulating Hormone ◽  
Short Term ◽  
The Mean ◽  
Early Rise ◽  
State Concentration ◽  
Male Subjects ◽  
Stimulating Hormone

Nine normal, healthy male subjects had significantly elevated thyroid-stimulating hormone (TSH) concentrations while receiving oral lithium carbonate for two weeks. The mean minimum lithium serum concentration was 0.765 mEq/L. The TSH concentrations after 15 days on lithium were significantly correlated to the TSH concentration at baseline. No correlation was found between mean minimum lithium steady-state concentration and TSH concentration after 15 days on lithium. Further research is necessary to determine if a high baseline TSH concentration or an early rise in TSH will predict those patients who will eventually develop hypothyroidism after long-term lithium therapy.

Sensitivity of rat adenohypophyseal cells to estradiol and LHRH during long-term culture

1981 ◽  
Vol 240 (6) ◽  
pp. E602-E608
Author(s):  
L. Lagace ◽  
F. Labrie ◽  
T. Antakly ◽  
G. Pelletier
Keyword(s):  
Luteinizing Hormone ◽  
Cell Types ◽  
Thyroid Stimulating Hormone ◽  
Time Interval ◽  
Pituitary Cells ◽  
Luteinizing Hormone Releasing Hormone ◽  
Lh Release ◽  
Lh Rh ◽  
Stimulating Hormone

To determine possible effects of the time in culture on the responsiveness of the different pituitary cell types to estrogens, rat anterior pituitary cells were incubated up to 20 days in the presence or absence of 10 nM 17 beta-estradiol. Whereas spontaneous luteinizing hormone (LH) and thyroid-stimulating hormone (TSH) release decreased by 85-90%, follicle-stimulating hormone (FSH) and prolactin accumulation in medium were only 50% decreased after 20 days in culture, thus suggesting that the secretion of FSH and prolactin is less dependent on extrinsic stimulatory factors. Estradiol increased spontaneous LH release and its responsiveness to luteinizing hormone-releasing hormone (LH-RH) up to day 16 in culture, whereas the stimulatory effect of the estrogen on FSH secretion was significant only up to day 6. The stimulatory effect of estradiol on basal TSH release was seen up to day 8 in culture, whereas that on spontaneous prolactin release increased progressively after day 8 in culture up to the last time interval studied (20 days). As revealed by immunocytochemistry, the stimulatory effect of estradiol was not due to changes of cell growth.

Use of morning serum cortisol level after transsphenoidal resection of pituitary adenoma to predict the need for long-term glucocorticoid supplementation

2009 ◽  
Vol 111 (3) ◽  
pp. 540-544 ◽  
Author(s):  
Nicholas F. Marko ◽  
Vivek A. Gonugunta ◽  
Amir H. Hamrahian ◽  
Ali Usmani ◽  
Marc R. Mayberg ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Cortisol Level ◽  
Postoperative Period ◽  
Serum Cortisol ◽  
Early Postoperative Period ◽  
Serum Cortisol Level ◽  
Total Serum ◽  
Total Cortisol ◽  
Hpa Function

Object Accurate assessment of the hypothalamic-pituitary-adrenal (HPA) axis is critical for appropriate management of the disease in patients with pituitary adenoma after transsphenoidal resection. The authors examine the role of the morning total serum cortisol level in the early postoperative period as a predictor of long-term HPA function. Methods Morning total serum cortisol was measured in 83 patients on postoperative Day 1 (or Day 2 if the patient received glucocorticoids during surgery) after transsphenoidal surgery for pituitary adenoma. These results were compared with those of definitive assays of HPA function performed at 1–3 months postoperatively, including cortrosyn/synacthen stimulation test (CST), insulin tolerance test (ITT), and metyrapone test (MTT). The ability of the early-postoperative morning cortisol level to predict HPA function was determined using standard confusion matrix calculations and receiver-operator control curve analysis. Results The authors found that an early postoperative morning total cortisol level ≥ 15 μg/dl is a sensitive and accurate predictor of normal HPA function in the postoperative period (sensitivity 80.5%, specificity 66.7%, positive predictive value 96.9%). Conclusions A morning total cortisol level ≥ 15 μg/dl in the early postoperative period after transsphenoidal surgery for pituitary adenomas is a good predictor of normal HPA function. This test has good sensitivity and accuracy and correlates well with the results of additional, definitive assays of HPA function (CST, ITT, and MTT) performed at 1–3 months postoperatively. Accordingly, it is the authors' practice to avoid exogenous perioperative glucocorticoid supplementation in patients with normal preoperative HPA function and postoperative morning total cortisol levels ≥ 15 μg/dl 1–2 days after transsphenoidal pituitary adenomectomy.

scholarly journals MRI of the TSH(Thyroid Stimulating Hormone) -Secreting Pituitary Adenoma

1995 ◽  
Vol 32 (1) ◽  
pp. 45
Author(s):  
Dong Ik Kim ◽  
Eun Gig Lee ◽  
Byung Chul Kang ◽  
Tae Sup Chung ◽  
Yong Kook Cho ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Thyroid Stimulating Hormone ◽  
Stimulating Hormone
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