ketendoКлиническая и экспериментальная тиреоидологияClinical and experimental thyroidology1995-54722310-3787Endocrinology Research Centre10.14341/ket20117268-73ketendo-4365Research ArticleСтатьиArticlesТиреотропинома: трудности дифференциальной диагностики (Клинический случай)Thyrotropin-producing adenoma: diagnostic challenges (Сase report)PrgijalkovskajaE G

канд. мед. наук, научный сотрудник отделения нейроэндокринологии и остеопатий ФГУ Эндокринологический научный центр Минздравсоцразвития РФ

-GasisovaD O

аспирант ФГУ Эндокринологический научный центр Минздравсоцразвития РФ

daria.gazizova@gmail.comGrigorievA Yu

канд. мед. наук, заведующий отделением нейрохирургии ФГУ Эндокринологический научный центр Минздравсоцразвития РФ

-VoronkovaI A

аспирант ФГУ Эндокринологический научный центр Минздравсоцразвития РФ

-TyulpakovA N

доктор мед. наук, заведующий отделением наследственных эндокринопатий ФГУ Эндокринологический научный центр Минздравсоцразвития РФ

-RochinskajaL Ya

доктор мед. наук, заведующая отделением нейроэндокринологии и остеопатий ФГУ Эндокринологический научный центр Минздравсоцразвития РФ

-20111506201172ТОМ 7, №2 (2011)6873Copyright © Prgijalkovskaja E.G., Gasisova D.O., Grigoriev A.Y., Voronkova I.A., Tyulpakov A.N., Rochinskaja L.Y., 20112011Prgijalkovskaja E.G., Gasisova D.O., Grigoriev A.Y., Voronkova I.A., Tyulpakov A.N., Rochinskaja L.Y.Prgijalkovskaja E.G., Gasisova D.O., Grigoriev A.Y., Voronkova I.A., Tyulpakov A.N., Rochinskaja L.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.cet-endojournals.ru/jour/article/view/4365

Тиреотропинома – одна из редких причин развития тиреотоксикоза. Ошибки в дифференциальной диагностике с другими причинами тиреотоксикоза ведут к необоснованному проведению хирургического вмешательства на щитовидной железе или радиойодтерапии. В статье представлены современные данные об особенностях патогенеза, диагностики, дифференциальной диагностики и лечения ТТГ-секретирующих аденом; описан клинический случай тиреотропиномы у молодой женщины.

Pituitary thyrotropin-producing adenomas (TSH-omas) are rare tumors that cause hyperthyroidism. Failure to recognize this disease may result in dramatic consequences, such as improper thyroid ablation in patients with central hyperthyroidism. This article concerns the current issues of pathogenesis, diagnostics, differential diagnostics and treatment of TSH-omas. It also describes a case study of a young woman with thyrotropin-producing adenoma.

тиреотропиноматиреотоксикозаденома гипофизаthyrotropin-producing adenomathyrotoxicosissyndrome of resistance to thyroid hormoneReferencesКадашев Б.А., Астафьева Л.И. Аденомы гипофиза. Тверь, 2007. С. 152–155.Кадашев Б.А., Астафьева Л.И. Аденомы гипофиза. Тверь, 2007. С. 152–155.Ando S., Sarlis N.J., Krishan J. et al. Abberant alternative splicing of thy-roid hormone receptor in a TSH-secreting pituitary tumor is a mechanism for hormone resistance // Mol. Endocr. 2001. V. 15. P. 1529.Ando S., Sarlis N.J., Krishan J. et al. Abberant alternative splicing of thy-roid hormone receptor in a TSH-secreting pituitary tumor is a mechanism for hormone resistance // Mol. Endocr. 2001. V. 15. P. 1529.Ando S., Sarlis N.J., Oldfield E.H., Yen P.M. Somatic mutation of TRbeta can cause a defect in negative regulation of TSH in a TSH-secreting pituitary tumor // J. Clin. Endocr. Met. 2001. V. 86. P. 5572.Ando S., Sarlis N.J., Oldfield E.H., Yen P.M. Somatic mutation of TRbeta can cause a defect in negative regulation of TSH in a TSH-secreting pituitary tumor // J. Clin. Endocr. Met. 2001. V. 86. P. 5572.Baur A., Buchfelder M., Kohrle J. Expression of 5'-deiodinase enzymes in normal pituitaries and in various human pituitary adenomas // Eur. J. Endocr. 2002. V. 147. P. 263.Baur A., Buchfelder M., Kohrle J. Expression of 5'-deiodinase enzymes in normal pituitaries and in various human pituitary adenomas // Eur. J. Endocr. 2002. V. 147. P. 263.Beck-Peccos P., Brueker-Davis F., Persani L. et al. Thyrotropin-secreting pituitary tumors // Endocr. Rev. 1996. V. 17. P. 610.Beck-Peccos P., Brueker-Davis F., Persani L. et al. Thyrotropin-secreting pituitary tumors // Endocr. Rev. 1996. V. 17. P. 610.Beck-Peccoz P., Persani L. TSH-induced hyperthyroidism caused by a pituitary tumor. Nat.Clin. Pract. Endocrinol. Metab. 2006. V.2 (9). P. 524–528.Beck-Peccoz P., Persani L. TSH-induced hyperthyroidism caused by a pituitary tumor. Nat.Clin. Pract. Endocrinol. Metab. 2006. V.2 (9). P. 524–528.Beck-Peccos P., Roncoroni R., Mariotti S. et al. Sex hormone-binding globulin measurement in patients with inappropriate secretion of thyrotropin (1ST): evidence against selective pituitary thyroid hormone resistance in non-neoplastic 1ST // J. Clin. Endocr. Met. 1990. V. 71. P. 19.Beck-Peccos P., Roncoroni R., Mariotti S. et al. Sex hormone-binding globulin measurement in patients with inappropriate secretion of thyrotropin (1ST): evidence against selective pituitary thyroid hormone resistance in non-neoplastic 1ST // J. Clin. Endocr. Met. 1990. V. 71. P. 19.Chanson P., Weintraub B.D., Harris A.G. Octreotide therapy for thyroid stimulating hormone-secreting pituitary adenomas: A follow up of 52 patients // Ann. Intern. Med. 1993. V. 119. P. 236.Chanson P., Weintraub B.D., Harris A.G. Octreotide therapy for thyroid stimulating hormone-secreting pituitary adenomas: A follow up of 52 patients // Ann. Intern. Med. 1993. V. 119. P. 236.Chatterjee V.K.K., Clifton-Bright R.J., Gurnell M. Thyroid hormone resistance. In: Jameson JL, ed: Contemporary Endocrinology: Hormone Resistance Syndromes. Totowa. Humana Press, 1999. Р. 145–153Chatterjee V.K.K., Clifton-Bright R.J., Gurnell M. Thyroid hormone resistance. In: Jameson JL, ed: Contemporary Endocrinology: Hormone Resistance Syndromes. Totowa. Humana Press, 1999. Р. 145–153Dong Q., Brucker-Davis F., Weintraub B.D. et al. Screening of candidate oncogenes in human thyrotropin tumors: absence of activating mutations of the Gall, Gas, or thyrotropin-releasing hormone receptor genes // J. Clin. Endocr. Met. 1996. V. 81. P. 1134.Dong Q., Brucker-Davis F., Weintraub B.D. et al. Screening of candidate oncogenes in human thyrotropin tumors: absence of activating mutations of the Gall, Gas, or thyrotropin-releasing hormone receptor genes // J. Clin. Endocr. Met. 1996. V. 81. P. 1134.Gesundheit N., Petrick P., Nissim M. et al. Thyrotropin-secreting pituitary adenomas: clinical and biochemical heterogeneity // An. Intern. Med. 1989. V. 111. P. 827.Gesundheit N., Petrick P., Nissim M. et al. Thyrotropin-secreting pituitary adenomas: clinical and biochemical heterogeneity // An. Intern. Med. 1989. V. 111. P. 827.Ghannam N.N., Hammami M.M., Muttair Z. et al. Primary hypothyroidism – associated TSH-secreting pituitary adenoma/hyperplasia presenting as a bleed-ing nasal mass and extremely elevated TSH level // J. Endocr. Invest. 1999. V. 22. P. 419.Ghannam N.N., Hammami M.M., Muttair Z. et al. Primary hypothyroidism – associated TSH-secreting pituitary adenoma/hyperplasia presenting as a bleed-ing nasal mass and extremely elevated TSH level // J. Endocr. Invest. 1999. V. 22. P. 419.Hamilton C., Adams L.C., Maloof F. Hyperthyroidism due to thyrotropin-producing pituitary chromophobe adenoma // N. Engl. J. Med. 1970. V. 283. P. 1077.Hamilton C., Adams L.C., Maloof F. Hyperthyroidism due to thyrotropin-producing pituitary chromophobe adenoma // N. Engl. J. Med. 1970. V. 283. P. 1077.Jailer J.W., Holub D.A. Remission of Graves' disease following radiother-apy of a pituitary neoplasm // Am. J. Med. 1960. V. 28. P. 497.Jailer J.W., Holub D.A. Remission of Graves' disease following radiother-apy of a pituitary neoplasm // Am. J. Med. 1960. V. 28. P. 497.Losa M., Magnani P., Mortini P. et al. Indium-Ill pentetreotide single-photon emission tomography in patients with TSH-secreting pituitary adenomas: correlation with the effect of a single administration of octreotide on cerum TSH levels // Eur. J. Nucl. Med. 1997. V. 24. P. 728.Losa M., Magnani P., Mortini P. et al. Indium-Ill pentetreotide single-photon emission tomography in patients with TSH-secreting pituitary adenomas: correlation with the effect of a single administration of octreotide on cerum TSH levels // Eur. J. Nucl. Med. 1997. V. 24. P. 728.Mindermann Т., Wilson C.B. Thyrotropin-producing pituitary adenomas // J. Neurosurg. 1993. V. 79. P. 521.Mindermann Т., Wilson C.B. Thyrotropin-producing pituitary adenomas // J. Neurosurg. 1993. V. 79. P. 521.Mixson A.J., friedman T.C., David A.K. et al. Thyrotropin-secreting pitui-tary carcinoma // J. Clin. Endocr. Met. 1993. V. 76. P. 529.Mixson A.J., friedman T.C., David A.K. et al. Thyrotropin-secreting pitui-tary carcinoma // J. Clin. Endocr. Met. 1993. V. 76. P. 529.Nabarro J.D.N. Acromegaly // Clin. Endocr. 1987. V. 26. P. 481.Nabarro J.D.N. Acromegaly // Clin. Endocr. 1987. V. 26. P. 481.Persani L., Preziati D., Matthews C.H. et al. Serum levels of carboxyterminal cross-linked telopeptide of type I collagen (ICTP) in the differential diagno-sis of the syndromes of inappropriate secretion of TSH // Clin. Endocr. 1997. V. 47. P. 207.Persani L., Preziati D., Matthews C.H. et al. Serum levels of carboxyterminal cross-linked telopeptide of type I collagen (ICTP) in the differential diagno-sis of the syndromes of inappropriate secretion of TSH // Clin. Endocr. 1997. V. 47. P. 207.Sanno N., Teramoto A., Matsuno A. et al. Clinical and immunohistochemical studies on TSH-secreting pituitary adenoma: its multihormonality and expression of Pit-1 // Mod. Pathol. 1994. V. 7. P. 893.Sanno N., Teramoto A., Matsuno A. et al. Clinical and immunohistochemical studies on TSH-secreting pituitary adenoma: its multihormonality and expression of Pit-1 // Mod. Pathol. 1994. V. 7. P. 893.Smallridge R.C. Metabolic, physiologic and clinical indexes of thyroid function. Werner and Ingbar's The Thyroid. 7th ed. Philadelphia: Lippincott, 1996. P. 397.Smallridge R.C. Metabolic, physiologic and clinical indexes of thyroid function. Werner and Ingbar's The Thyroid. 7th ed. Philadelphia: Lippincott, 1996. P. 397.Tannahill L.A., Visser T.J., McCabe C.J. et al. Disregulation of iodothyronine deiodinase enzyme expression and function in human pituitary tumors // Clin. Endocr. 2002. V. 56. P. 735.Tannahill L.A., Visser T.J., McCabe C.J. et al. Disregulation of iodothyronine deiodinase enzyme expression and function in human pituitary tumors // Clin. Endocr. 2002. V. 56. P. 735.Terzolo M., Orlandi F., Basseti M. et al. Hyperthyroidism due to a pituitary adenoma composed of two different cell types, one secreting alpha-subunit alone and another cosecreting alpha-subunit and thyrotropin // J. Clin. Endocr. Met. 1991. V. 72. P. 415.Terzolo M., Orlandi F., Basseti M. et al. Hyperthyroidism due to a pituitary adenoma composed of two different cell types, one secreting alpha-subunit alone and another cosecreting alpha-subunit and thyrotropin // J. Clin. Endocr. Met. 1991. V. 72. P. 415.Yamakita N., Ikeda Т., Murai T. et al. Thyrotropin-producing pituitary adenoma discovered as a pituitary incidentaloma. Intern Med. 1995. V. 34 (11). P. 1055–1060.Yamakita N., Ikeda Т., Murai T. et al. Thyrotropin-producing pituitary adenoma discovered as a pituitary incidentaloma. Intern Med. 1995. V. 34 (11). P. 1055–1060.

The authors declare that there are no conflicts of interest present.