{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T14:09:41Z","timestamp":1768745381379,"version":"3.49.0"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:00:00Z","timestamp":1768435200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Thyroid-stimulating hormone pituitary adenomas (TSHomas) are a rare cause of central hyperthyroidism, characterized by abnormally high TSH levels, and typically respond to somatostatin analogue (SSA). We report a young patient with SSA-insensitive TSHoma where Lugol\u2019s solution facilitated surgical preparation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 28-year-old male patient presented with a 1.5-year history of headache and visual loss. Thyroid function revealed elevated levels of free triiodothyronine (FT3) 45.87 pmol\/L, free thyroxine (FT4) exceeding 100 pmol\/L, and non-suppressed TSH 6.66 mIU\/L. Magnetic resonance imaging (MRI) suggested a large pituitary adenoma (19 \u00d7 25 \u00d7 23 mm). Initial long-acting octreotide treatment was ineffective in controlling hyperthyroidism and was discontinued after 5 months. Approximately 1 year after the initial presentation, reassessment showed persistently elevated thyroid hormone levels. A TSH suppression test indicated octreotide sensitivity at 55%. An oral glucose tolerance test (OGTT) suggested concomitant growth hormone (GH) excess. Preoperatively, treatment with short-acting octreotide, methimazole, and Lugol\u2019s solution effectively controlled thyroid hormone levels. The patient subsequently underwent transnasal adenomectomy. Histopathology confirmed a PIT-1-positive pituitary adenoma, with TSH, GH, and prolactin (PRL) positivity. At the 3-month follow-up, thyroid hormone, GH, and insulin-like growth factor-1 (IGF-1) levels had normalized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case highlights Lugol\u2019s solution as a rescue therapy for SSA-insensitive TSH\/GH co-secreting pituitary adenomas. Despite SSTR2\/5 positivity, suboptimal response to octreotide suggests tumor heterogeneity or downstream signaling defects. Preoperative Lugol\u2019s solution should be considered when SSAs and methimazole fail.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2025.1698948","type":"journal-article","created":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T05:17:10Z","timestamp":1768454230000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Lugol\u2019s solution for preoperative management of a TSH\/GH-secreting pituitary adenoma with suboptimal response to octreotide: a case report"],"prefix":"10.3389","volume":"16","author":[{"given":"Guiliang","family":"Peng","sequence":"first","affiliation":[{"name":"Department of Endocrinology, The First Affiliated Hospital (Southwest Hospital) of Army Medical University","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaotian","family":"Lei","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, The First Affiliated Hospital (Southwest Hospital) of Army Medical University","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weiling","family":"Leng","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, The First Affiliated Hospital (Southwest Hospital) of Army Medical University","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Pathology, The First Affiliated Hospital (Southwest Hospital) of Army Medical University","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laiping","family":"Xie","sequence":"additional","affiliation":[{"name":"The Department of Nuclear Medicine, The First Affiliated Hospital (Southwest Hospital) of Army Medical University","place":["Chongqing, 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