Surgical management of clinically silent thyrotropin pituitary adenomas: A single center series of 20 patients.

•Silent TSHomas tend to be large, invasive tumors often presenting with symptoms of mass effect.•Silent TSHomas often express immunopositivity for alpha-subunit and gonadotropins, supporting a primitive adenoma subtype.•Despite reoperation in several patients, good overall outcomes with low complication rates were achieved.