Short-term preoperative octreotide treatment for TSH-secreting pituitary adenoma

Endocrine Journal

Akira Takeshita²  Kentaro Horiguchi¹  Shozo Yamada¹  Noriaki Fukuhara¹  Hiroshi Nishioka¹  Naoko Inoshita³  Hisanori Suzuki²  Yasuhiro Takeuchi² 

[1] Department of Hypothalamic and Pituitary Surgery, Toranomon Hospital, Tokyo, Japan;Department of Endocrinology and Metabolism, Toranomon Hospital, Tokyo, Japan;Department of Pathology, Toranomon Hospital, Tokyo, Japan

关键词: TSH-secreting pituitary adenoma;    Octreotide;    Preoperative treatment;    Outcome;   

DOI  :  10.1507/endocrj.EJ14-0118

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(13)Cited-By(1)Preoperative control of hyperthyroidism in patients with TSH-secreting pituitary adenomas (TSHoma) may avoid perioperative thyroid storm.Perioperative administration of octreotide may control hyperthyroidism, as well as shrink tumor size.The effects of preoperative octreotide treatment were assessed in a large number of patients with TSHomas.Of 81 patients who underwent surgery for TSHoma at Toranomon Hospital between January 2001 and May 2013, 44 received preoperative short-term octreotide.After excluding one patient because of side effects, 19 received octreotide as a subcutaneous injection, and 24 as a long-acting release (LAR) injection.Median duration between initiation of octreotide treatment and surgery was 33.5 days.Octreotide normalized free T4 in 36 of 43 patients (84%) and shrank tumors in 23 of 38 (61%).Length of octreotide treatment did not differ significantly in patients with and without hormonal normalization (p = 0.09) and with and without tumor shrinkage (p = 0.84).Serum TSH and free T4 concentrations, duration of treatment, incidence of growth hormone (GH) co-secretion, results of octreotide loading tests, form of administration (subcutaneous injection or LAR), tumor volume, and tumor consistency did not differ significantly in patients with and without hormonal normalization and with and without tumor shrinkage.Short-term preoperative octreotide administration was highly effective for TSHoma shrinkage and normalization of excess hormone concentrations, with tolerable side effects.

【 授权许可】

Unknown