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[Hyperthyroidism caused by a TSH producing pituitary adenoma].

F Prasch1, S E Knosp, R Steinbach

  • 1Institut für Nuklearmedizin, Krankenhaus Lainz.

Acta Medica Austriaca
|May 7, 1999
PubMed
Summary

A TSH-secreting pituitary adenoma was diagnosed in a patient with elevated thyroid hormones and TSH. Surgical removal normalized hormone levels, confirming neoplastic inappropriate secretion of TSH (nIST).

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Area of Science:

  • Endocrinology
  • Oncology
  • Neurosurgery

Background:

  • Inappropriate secretion of TSH (IST) is a rare condition characterized by elevated thyroid hormones and TSH.
  • Neoplastic IST (nIST) is typically caused by a TSH-secreting pituitary adenoma.

Observation:

  • A 53-year-old patient presented with elevated free triiodothyronine (fT3) and free thyroxine (fT4) levels, alongside elevated thyrotropin (TSH).
  • Further tests showed a blunted TSH response to TRH and lack of suppression with T3, alongside elevated alpha-TSH and SHBG.
  • Magnetic resonance imaging (MRI) revealed a 1 cm pituitary tumor.

Findings:

  • The patient was diagnosed with neoplastic inappropriate secretion of TSH (nIST) due to a TSH-secreting pituitary adenoma.
  • Transsphenoidal resection successfully removed the adenoma, evidenced by undetectable postoperative TSH levels.

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  • Post-surgery, fT3 and fT4 levels normalized, and follow-up imaging showed no residual tumor uptake.

    • Implications:

    • This case highlights the diagnostic challenges and successful management of nIST.
    • Early diagnosis and surgical intervention are crucial for favorable outcomes in patients with TSH-secreting pituitary adenomas.
    • The findings underscore the importance of comprehensive endocrine evaluation in patients with unexplained thyroid dysfunction.