[Pituitary enlargement with primary hypothyroidism. Report of a case with hyperprolactinemia]

A thirty-nine-year-old house-wife having two children manifested amenorrhea and galactorrhea, since two years before admission. At the same time, she also showed hypothyroidism with high level of serum TSH, which was very sensitive to TRH. Contrast enhanced CT revealed intrasellar mass. Transsphenoidal operation was performed, which revealed a soft, suckable and hypovascularized pituitary mass. The border between the mass and normal pituitary was not clear. Histological diagnosis was pituitary hyperplasia under light and electron microscopy. Before surgery, we were not sure whether this case was primary pituitary tumor or secondary pituitary mass due to hypothyroidism, because we had not been doing thyroid replacement before operation. In this paper, we stress that first choice of treatment for this type of tumor should be thyroid replacement therapy and that, if that replacement therapy failed, pituitary surgery should be the second choice.