Thyrotropinoma: What to Do When Surgery and Medical Treatment Are Contraindicated or Declined

This protocol addresses the patient with thyrotropinoma in whom prior medical therapy did not achieve its defined goals, and for whom surgical intervention is now contraindicated or has been declined. A distinct treatment pathway is indicated in this setting.

The preceding step was medical treatment with long-acting somatostatin analogs (octreotide LAR, lanreotide SR, or lanreotide Autogel) or dopamine agonists (bromocriptine or cabergoline).

When both surgery and medical treatment are contraindicated or declined, a targeted radiation-based approach directed at the pituitary is considered. The complete regimen — including which specific modality applies and how care is sequenced — is set out in the full structured protocol.

Technique selection, sequencing, and all quantitative parameters are not shown on this page.