{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T11:19:20Z","timestamp":1778325560261,"version":"3.51.4"},"reference-count":39,"publisher":"Endocrinology Research Centre","issue":"2","license":[{"start":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T00:00:00Z","timestamp":1695772800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.probl-endojournals.ru\/jour\/about\/editorialPolicies#openAccessPolicy"}],"content-domain":{"domain":["www.probl-endojournals.ru"],"crossmark-restriction":true},"short-container-title":["Probl Endokrinol (Mosk)"],"abstract":"<jats:p><jats:bold>BACKGROUND<\/jats:bold>: Thyrotropin-secreting pituitary adenomas (TSH-PA) are a rare cause of thyrotoxicosis and account for 0.5-2% of all pituitary adenomas. Taking into account the rarity of the disease, it is extremely important to analyze each case of TSH-PA. AIM: To analyze the clinical characteristics and treatment outcomes of patients with TSH-PA, as well as to determine preoperative and early postoperative factors that predict long-term remission.<\/jats:p><jats:p><jats:bold>MATERIALS AND METHODS<\/jats:bold>: In a single-center retrospective study we analyzed clinical signs, laboratory and instrumental studies, as well as the treatment outcomes of patients with TSH-PA from 2010 to 2023. Preoperative factors, as well as TSH level measured on day 3 postoperatively, were evaluated for their ability to predict long-term remission when comparing groups of patients with and without remission. RESULTS: The study included 45 patients with TSH-PA (14 men, 31 women), with a median age of 45 years [30; 57]. The most common clinical manifestations of TSH-PA were: cardiac arrhythmia in 37 (82.2%) patients, thyroid pathology in 27 (60%), neurological disorders in 24 (53.35%). Most PAs were macroadenomas (n=35, 77.8%). Preoperatively, 28 (77.8%) patients received somatostatin analogs, and 20 (71.4%) patients were euthyroid at the time of surgery. Surgical treatment was performed in 36 (80%) patients, postoperative remission was achieved in 31 cases (86.1%). Administration of somatostatin analogues to patients with no remission\/relapse after surgery lead to the remission in 100% of cases (4\/4). A 1 mm increase in PA size raised the odds of recurrence\/no remission by 1.15-fold,and PA invasion during surgery \u2014 by \u00a05.129 fold. A TSH level on day 3 postoperatively above 0.391 mIU\/L (AUC, 0.952; 95% CI 0.873\u20131.000; standard error 0.04; p&lt;0.001) identifies patients with relapse\/absence of remission after surgical treatment (sensitivity = 100%, specificity = 88.9%).<\/jats:p><jats:p><jats:bold>CONCLUSION<\/jats:bold>: The TSH-PA in the structure of PAs is extremely rare, and as a result, most of them are misdiagnosed and detected already at the stage of macroadenoma. The most effective method of treatment is transnasal transsphenoidal adenomectomy. Somatostatin analogues can be used as second-line therapy if surgical treatment is ineffective. We have proposed a possible model for postoperative TSH levels (&gt;0.391 mU\/l) to predict recurrence of TSH-PA, which requires validation on an expanded number of cases.<\/jats:p>","DOI":"10.14341\/probl13325","type":"journal-article","created":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T15:18:14Z","timestamp":1716391094000},"page":"23-36","update-policy":"https:\/\/doi.org\/10.14341\/crossmarkpolicy2018","source":"Crossref","is-referenced-by-count":3,"title":["Thyrotropin-secreting pituitary adenomas: clinical features and results of treatment in 45 patients"],"prefix":"10.14341","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1359-8297","authenticated-orcid":true,"given":"D. 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Thyrotropin-secreting pituitary adenomas: outcome of pituitary surgery and irradiation. 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