The rare patients who have TSH-secreting adenoma present with increased serum levels of TSH and symptomatic thyrotoxicosis. They are usually treated surgically58,59 (see Chap. 15 and Chap. 42). Some suppression of TSH has been observed with bromocriptine therapy, but this has been inadequate to normalize thyroid hormone levels; a slight reduction in tumor size was reported in one patient. Conventional antithyroid therapy treats the thyrotoxicosis but not the primary lesion. Trials with octreotide acetate, however, appear promising.47,60