Thyrotropin-secreting pituitary carcinoma.

摘要: Pituitary tumors rarely metastasize outside the central nervous system. Of more than 100 reported TSH-secreting adenomas, we now describe first carcinoma. A 40-yr-old woman had transsphenoidal surgery for a large pituitary adenoma in 1984. She increased thyroid hormone levels with TSH that varied from 16-31 microU/mL, and an unusually high alpha-subunit ranged 125-150 ng/mL. Because of residual tumor, she left craniotomy 1985 followed by radiation. Despite these therapies, tumor remained stable until January 1989 when her nearly doubled size. received radiation therapy octreotide marked diminution clinical improvement. In August 1989, presented leg weakness, magnetic resonance imaging revealed sacral mass. biopsy confirmed mass was metastasis tumor. Due to additional metastases lung, 5-fluorouracil, cytoxan, adriamycin, decrease lesions. Further substantiation metastatic made patient returned December pleural effusion containing cells. all cases this case highest portending future metastases. Furthermore, apparent response chemotherapy are encouraging suggest new therapies should be explored. Finally, since adenomas tend invasive other tumors, underscores need early diagnosis aggressive treatment tumors.