A Case Report of a Thyrotropin-Secreting Pituitary Macroadenoma

Thyroid-stimulating hormone (TSH)-secreting pituitary adenoma is a rare case that is characterized by high or inappropriately normal thyrotropin levels along with an increase in thyroid hormones that lead, in most of the patients, to signs and symptoms similar to those of hyperthyroidism problems. Its diagnosis and management are still challenging. A 65-year-old male patient presented to the emergency department for palpitations. He was firstly misdiagnosed due to incomplete lab tests. After a full workup, he was found to have TSH-secreting pituitary adenoma and referred to trans-sphenoidal surgery for macroadenoma excision. Currently, he is maintained on somatostatin analogue and methimazole. This is the second case report of TSHoma in Lebanon with signs and symptoms of thyrotoxicosis. Usually, the clinical features of TSHomas vary between patients which makes the confirmation of diagnosis more difficult. Surgery is still the first line of treatment with the addition of encouraging effects of medical therapy consisting of somatostatin analogues.