Thyrotrophin (TSH) - Secreting Pituitary Macroadenoma with Cavernous Sinus Invasion

YC Kon, KC Loh, JA Tambyah, LH Lim, JC Marshall
Correspondence: Dr Loh Keh Chuan, keh_chuan_loh@ttsh.com.sg

ABSTRACT
Thyrotrophin (TSH)-secreting pituitary adenomas, although rare, should be recognised as a possible cause of normal or elevated serum TSH in the presence of elevated serum free thyroid hormone levels. Clinical hyperthyroidism may be mild or absent. Early recognition provides the best chance for surgical cure. We report a patient with a TSH-secreting pituitary tumour with cavernous sinus invasion. This case illustrates that multiple modalities of treatment are often necessary and complementary in achieving control of tumour growth and hormonal hypersecretion when these tumours are diagnosed late.

Keywords: Thyrotrophin-secreting tumour, pituitary macroadenoma, gamma-knife radiosurgery, somatostatin analogues
Singapore Med J 2001; 42(9): 433-437