Thyrotropinomas: Presentation of Three Cases and Review of Literature

Thyrotropinomas are rare pituitary tumors that are difficult to diagnose due to their variety of clinical presentations. We describe three patients with thyrotropinoma and review the management of this disease based on current literature. Patient 1 had a typical acromegalic phenotype with a pituitary adenoma that secreted both growth hormone (GH) and thyroid-stimulating hormone (TSH). Patient 2 underwent pituitary surgery without antithyroid treatment; this tumor was also positive for both TSH and GH on pathological examination, and the patient experienced transient central hypothyroidism postoperatively. Patient 3, who had both a thyrotropinoma and autoimmune thyroiditis, underwent surgery after one year of treatment with lanreotide; the removed pituitary adenoma was positive only for TSH. To our knowledge, concomitant Graves’ disease and thyrotropinoma is very rare, with only two patients previously reported. In conclusion, thyrotropinomas are increasingly being encountered when they are smaller, which has improved patient prognosis. Nevertheless, the diagnosis and perioperative management of thyrotropinomas remain challenging, which suggests that patients with such tumors should be managed by endocrinologists.