Unusual association between a thyrotropin-secreting pituitary adenoma and a papillary thyroid carcinoma.
We report here an unusual case of association between thyrotropin (TSH)-secreting pituitary adenoma and papillary thyroid carcinoma in a young female patient. Serum TSH levels did not significantly change after both stimulatory (thyrotropin-releasing hormone [TRH], domperidone) and inhibitory (bromocriptine levotriiodothyronine, [LT3], levothyroxine [LT4], LT4 plus LT3) tests, while a 67% decrease of serum TSH levels was obtained after acute administration of a somatostatin analog (SMS 201-995, 100 microg s.c.). Serum alpha-subunit levels and the alpha-subunit/TSH molar ratio were clearly elevated. Magnetic resonance imaging (MRI) revealed the presence of a pituitary adenoma (1 cm in diameter). Pitfalls arising from the failure to inhibit TSH secretion in a patient thyroidectomized for papillary cancer are discussed.
Gasparoni
P
P
Department of Endocrinology, University Hospital of Castelfranco Veneto, Italy.
Rubello
D
D
Persani
L
L
Beck-Peccoz
P
P
D000236:Adenoma / Q000175:diagnosis / Q000378:metabolism*; D000328:Adult; D002291:Carcinoma, Papillary / Q000097:blood*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009378:Neoplasms, Multiple Primary; D010908:Pituitary Hormones, Anterior / Q000097:blood; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000378:metabolism*; D013963:Thyroid Hormones / Q000097:blood; D013964:Thyroid Neoplasms / Q000097:blood*; D013972:Thyrotropin / Q000378:metabolism*
D010908:Pituitary Hormones, Anterior; D013963:Thyroid Hormones; D013972:Thyrotropin