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[Primary hypothyroidism mimicking pituitary macroadenoma]
Carolina C R Betônico1, Ricardo Rodrigues, Suzan C L Mendonça
1Departamento de Endocrinologia, Universidade Federal de Uberlândia, MG.
Arquivos Brasileiros De Endocrinologia E Metabologia
|January 11, 2005
Summary
A pituitary mass resolved with hypothyroidism treatment, highlighting the need for thyroid tests in pituitary evaluations. This case demonstrates pituitary hyperplasia secondary to primary hypothyroidism.
Area of Science:
- Endocrinology
- Neuroimaging
Background:
- Pituitary masses can present with diverse symptoms, including hormonal imbalances and neurological deficits.
- Distinguishing between neoplastic and functional pituitary lesions is crucial for appropriate management.
Observation:
- A 21-year-old woman presented with amenorrhea, weight gain, galactorrhea, and headaches, indicative of hormonal dysfunction.
- Laboratory tests revealed severe primary hypothyroidism (TSH: 1192 mUI/ml) and elevated prolactin (69.2 ng/ml).
- Magnetic resonance imaging (MRI) identified a suprasellar and intrasellar mass compressing the optic chiasm.
Findings:
- Treatment of hypothyroidism with levothyroxine led to the normalization of thyroid hormones and TSH levels.
- A follow-up MRI demonstrated complete regression of the pituitary mass, indicating pituitary hyperplasia secondary to hypothyroidism.
- The prolactin elevation resolved with thyroid hormone replacement therapy.
Implications:
- This case underscores the importance of thyroid function testing in the workup of pituitary masses.
- Prompt diagnosis and treatment of underlying endocrine disorders can prevent unnecessary surgical interventions for functional pituitary hyperplasia.
- Understanding the relationship between thyroid status and pituitary size is vital for accurate diagnosis and patient care.