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Thyrotropin-secreting pituitary adenoma
T J Chang1, T C Chang, S M Lin
1Department of Internal Medicine, En Chu Kong Hospital, Taipei Hsien, Taiwan.
Journal of the Formosan Medical Association = Taiwan Yi Zhi
|January 13, 1999
Summary
A rare thyrotropin (TSH)-secreting pituitary adenoma (TSPA) caused hyperthyroidism in a Taiwanese patient. Surgical removal of the pituitary microadenoma resolved symptoms, highlighting TSPA as a crucial differential diagnosis for hyperthyroidism.
Area of Science:
- Endocrinology
- Oncology
- Neurosurgery
Background:
- Thyrotropin (TSH)-secreting pituitary adenoma (TSPA) is an infrequent cause of hyperthyroidism.
- Detailed case reports from Taiwan are rare, necessitating further documentation.
Observation:
- A 42-year-old male presented with a two-year history of hyperthyroid symptoms including weight loss, palpitations, and anxiety.
- Elevated serum thyroxine (T4) and triiodothyronine (T3) with normal TSH and impaired TSH response to TRH stimulation were noted.
- Magnetic resonance imaging revealed a pituitary microadenoma, confirmed by high radioactive iodine uptake in the thyroid gland.
Findings:
- Trans-sphenoidal pituitary tumor excision successfully treated the TSPA.
- Post-operative follow-up showed no tumor recurrence or hyperthyroid symptoms, and no need for hormonal supplementation.
- Histologic examination and endocrine testing confirmed the diagnosis and surgical success.
Implications:
- TSPA should be considered in the differential diagnosis of hyperthyroidism, particularly in cases with normal or elevated TSH levels.
- This case underscores the importance of pituitary imaging and appropriate endocrine workup for unexplained hyperthyroidism.
- Successful surgical management of TSPA offers a curative option for this rare condition.