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National incidence and prevalence of TSH-secreting pituitary adenomas in Sweden
Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
Department of Endocrinology, Karolinska University Hospital Solna, Stockholm, Sweden.
Department of Endocrinology, Skåne University Hospital, Malmö-Lund, Sweden.
Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
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2013 (English)In: Journal of Clinical Endocrinology and Metabolism, ISSN 0021-972X, E-ISSN 1945-7197, Vol. 98, no 2, p. 626-635Article in journal (Refereed) Published
Abstract [en]

CONTEXT: TSH-secreting pituitary adenomas (TSHomas) are rare. Epidemiological data are scant and there are no reports on national incidence.

OBJECTIVE: The objective of the study was to estimate the national Swedish incidence and prevalence of TSHomas.

DESIGN: This was an observational study.

SETTING: The study was conducted at tertiary referral centers.

PATIENTS: The Swedish Pituitary Registry and World Health Organization International Statistical Classification of Diseases and Related Health Problems coding at all university hospitals were used to identify patients diagnosed with TSHomas 1990-2010. The identified patients' medical records were studied until the latest follow-up [median 5.0 years (range < 1-20 years)].

MAIN OUTCOME MEASUREMENTS: Incidence, prevalence, demographics, tumor characteristics, treatment outcome, and thyroid hormone level at diagnosis were measured.

RESULTS: The age-standardized national incidence of 28 TSHoma patients was 0.15 per 1 million inhabitants per year, with an increasing incidence over time (0.05 per 1 million per year in 1990-1994 to 0.26 per 1 million per year in 2005-2009). The national prevalence in 2010 was 2.8 per 1 million inhabitants, in which 0.85 per 1 million had active disease. Most patients (n = 22) underwent pituitary surgery, 5 had radiotherapy, and 6 had somatostatin analogues. Eighteen patients were considered cured at the latest follow-up; 25% remained uncontrolled. Subjects treated for putative primary hyperthyroidism prior to diagnosis had TSH levels more than double those with intact thyroid at diagnosis (P = .013). The median time to diagnosis was longer for women than men (4 vs < 1 year, P = .026). More women than men were treated surgically (94.1% vs 54.5%, P = .022).

CONCLUSION: This is the first estimate of a national incidence of TSHoma. Additional epidemiological studies are needed to compare these results with other geographical areas. This study suggests an increased incidence of TSHomas, in agreement with reports on other pituitary adenomas.

Place, publisher, year, edition, pages
Oxford University Press, 2013. Vol. 98, no 2, p. 626-635
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:oru:diva-110276DOI: 10.1210/jc.2012-3362ISI: 000316270900058PubMedID: 23295463Scopus ID: 2-s2.0-84873640201OAI: oai:DiVA.org:oru-110276DiVA, id: diva2:1819919
Funder
University of GothenburgSwedish Society for Medical Research (SSMF)
Note

Funding Agencies:

Sahlgren’s Academy at Gothenburg University

Swedish Society for Medical Research, Sweden

LUA/Alf agreement of Sahlgrenska University Hospital, Gothenburg and the Swedish Pituitary Registry

Available from: 2023-12-15 Created: 2023-12-15 Last updated: 2023-12-20Bibliographically approved

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Wahlberg, Jeanette

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