Endoscopic endonasal surgery is first-line treatment for most TSH-Secreting Adenomas
Thyrotropin-secreting adenomas (thyrotropinomas) result in excess blood thyroxin levels and are best treated with endoscopic endonasal removal.
Thyrotropin-secreting pituitary adenomas are a relatively rare cause of hyperthyroidism. Such “TSH-omas” account for approximately 1% of all pituitary adenomas. Once the cause of hyperthyroidism is determined to be central (associated with elevated TSH levels produced by a pituitary adenoma), normalization of thyroxin levels is critical prior to patients undergoing pituitary adenoma removal. First-line treatment of TSH-omas is transsphenoidal tumor removal. followed by irradiation in the case of surgical failure. However, medical treatment with somatostatin analogs, such as octreotide and lanreotide, are effective in reducing TSH secretion in more than 90% of cases with consequent normalization of FT4 and FT3 levels and restoration of the euthyroid state.
At Pacific Pituitary Disorders Center, we have one of the world’s largest experiences in endoscopic endonasal transsphenoidal surgery. With cutting-edge technology and instrumentation and proven surgical experience of over 1600 endonasal surgeries, we make pituitary adenoma surgery safer, less invasive and more effective. Center Director and Neurosurgeon Dr. Daniel Kelly and his neurosurgical partner Dr. Garni Barkhoudarian and ENT Surgeons Drs. Chester Griffiths and Kian Karimi, have one of the largest surgical experiences treating patients with pituitary adenomas, including TSH-omas.
Our highly experienced pituitary endocrinologists, led by Dr. Katherine Araque and colleagues Drs. Pejman Cohan and Sarah Rettinger can provide medical treatment of TSH-omas, typically with somatostatin analogs such as octreotide or lanreotide. For patients with TSH-omas that cannot be completely removed with endoscopic surgery or controlled with medications, our outstanding radiation oncologists can deliver focused radiosurgery or radiotherapy to tumors to help halt adenoma growth and normalize thyroxin levels.