title: Thyrotropinoma and multinodular goiter: A diagnostic challenge for hyperthyroidism.
abstract: Thyroid disorders are frequently encountered. The diagnosis is straightforward unless clinical or laboratory findings are inconclusive and/or perplexing. Hyperthyroidism due to a thyrotropin-secreting pituitary adenoma rarely occurs and symptoms due to thyroid hormone excess are subtle. The presentation of the disease becomes unusual when co-secretion of other hormones with thyrotropin or concomitant thyroid parenchymal pathology exist. We present the case of a 63-year-old female patient with thyrotropinoma co-secreting growth hormone and multinodular goiter. She developed hyperthyroidism first due to thyrotropinoma and later due to a toxic nodule. Herein, we discuss the diagnostic and therapeutic challenges of hyperthyroidism with atypical presentation.
authors: Department of Internal Medicine, Section of Endocrinology and Metabolism, Medical School, Hacettepe University, Ankara, Turkey.
authors: Duygu Yazgan
authors: DY
authors: Aksoy
authors: Department of Internal Medicine, Section of Endocrinology and Metabolism, Dokuz Eylul University, Izmir, Turkey.
authors: Arzu
authors: A
authors: Gedik
authors: Department of Internal Medicine, Section of Endocrinology and Metabolism, Medical School, Hacettepe University, Ankara, Turkey.
authors: Nese
authors: N
authors: Cinar
authors: Department of Pathology, Medical School, Hacettepe University, Ankara, Turkey.
authors: Figen
authors: F
authors: Soylemezoglu
authors: Department of Neurosurgery, Medical School, Hacettepe University, Ankara, Turkey.
authors: Mustafa
authors: M
authors: Berker
authors: Department of Internal Medicine, Section of Endocrinology and Metabolism, Medical School, Hacettepe University, Ankara, Turkey.
authors: Omer Alper
authors: OA
authors: Gurlek
keywords: Central hyperthyroidism; TSH-secreting adenoma; thyrotropinoma (TSHoma); toxic goiter; toxic nodular goiter