An inappropriate thyrotropin-secreting pituitary adenoma in a 30-year-old man

Thyrotropin-secreting pituitary adenomas are rare, especially in the family practice setting. We report a case of such a tumor and review the literature. The key clinical finding is hyperthyroidism in the absence of a suppressed thyrotropin level. The patient was unusual in not having an elevated alpha-subunit. All patients with hyperthyroidism should be screened for a thyrotropin level to rule out this unusual cause of hyperthyroidism. Other aspects of this case pertinent to primary care management are reviewed.