[Thyroid-stimulating hormone-secreting pituitary adenoma].
A 40-year-old male patient with a 2 years history of recurring hyperthyroidism is presented with clinical hyperthyroidism and diffuse goiter. Despite thyreostatic treatment and surgical thyroid ablation the hyperthyroidism recurred. The patient had laboratory evidence of hyperthyroidism and his serum TSH was persistently and enormously elevated (T4:214 nmol/l, T3:6.9 nmol/l, TSH:218 mIU/l)> Computed tomography and magnetic resonance imaging confirmed a pituitary mass of 7 cm in a-p diameter, with supra-, parasellar and sphenoidal extension. The pituitary adenoma was partially resected by transsphenoidal surgery, which failed to result in a substantial decrease in the serum thyrotropin level. Pituitary irradiation and a long-term somatostatin analog octreotide treatment (300-600 micrograms/die) combined with bromocriptine therapy resulted in a significant, but still incomplete suppression of thyrotropin secretion (TSH level about 15 mIU/l) and persisting mild hyperthyroidism. The size of the adenoma was unchanged during the two years of highdose octreotide treatment period. According to our best knowledge this is the first reported case of a thyrotropin-secreting pituitary adenoma in Hungary.
Tóth
M
M
II. Belgyógyászati Klinika, Semmelweis Orvostudományi Egyetem, Budapest.
Rácz
K
K
Kiss
R
R
Fütö
L
L
Varga
I
I
Karlinger
K
K
Dékány
E
E
Czirják
S
S
Pásztor
E
E
Gláz
E
E
D000328:Adult; D003131:Combined Modality Therapy; D006801:Humans; D006980:Hyperthyroidism / Q000209:etiology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D010910:Pituitary Irradiation; D010911:Pituitary Neoplasms / Q000150:complications / Q000175:diagnosis / Q000378:metabolism* / Q000601:surgery; D012008:Recurrence; D013972:Thyrotropin / Q000378:metabolism*; D014057:Tomography, X-Ray Computed
D013972:Thyrotropin
Thyreoidea stimuláló hormont termelö hypophysis adenoma.