Thyrotropin-secreting XXXX : epidemiology, diagnosis, and management.

@entity1 @entity5 @entity935 @entity1378 @entity977 @entity1943
UNASSIGNED: Inappropriate secretion of TSH was first described in 1960 in a @entity1 with evidence of @entity1378 and expanded sella on imaging. It was later found that a type of pituitary adenoma that secretes TSH (thyrotropinoma) was the underlying cause. The objective of the present review article is to summarize data on the epidemiology, pathogenesis, diagnosis, and management of thyrotropinomas. The prevalence of thyrotropinomas is lower than that of other @entity977 . Early diagnosis is now possible thanks to the availability of magnetic resonance imaging and sensitive laboratory assays. As a corollary, many @entity1 now present earlier in the course of their disease and have smaller @entity5 at the time of diagnosis. Treatment also has evolved over time. Transsphenoidal surgery is still considered definitive therapy. Meanwhile, radiation therapy, including radiosurgery, is effective in achieving @entity5 control in the majority of @entity1 . In the past, radiation therapy was used as second line treatment in @entity1 with residual or recurrent @entity5 after surgery. However, the availability of @entity1943 analogs, which can lead to normalization of thyroid function as well as shrink these @entity5 , has led to an increase in the role of medical therapy in @entity1 who are not in remission after pituitary surgery. In addition, @entity935 agonists have shown some efficacy in the management of these @entity5 . Better understanding of the molecular pathogenesis of thyrotropinomas may lead to rationally designed therapies for @entity1 with thyrotropinomas.
