Hyperthyroidism in a Patient with TSH-Producing Pituitary Adenoma Coexisting with Thyroid Papillary Adenocarcinoma

Endocrine Journal

TETSUYA OISHI¹  HIDEO KATAOKA¹  HIROFUMI MAKINO¹  TAKASHI TAMIYA⁵  KAZUAKI YOKOTA¹  TAKAYOSHI YAMAUCHI¹  MASAYUKI KISHIDA¹  TOSHIO OGURA⁴  YUKARI MIMURA³  HIROYOSHI DOIHARA²  FUMIO OTSUKA¹ 

[1] Departments of Medicine III, Okayama University Medical School;Surgery II, Okayama University Medical School;Faculty of Education, Okayama University;Health and Medical Center, Okayama University;Neurosurgery, Okayama University

关键词: TSH-producing pituitary adenoma;    Hyperthyroidism;    Thyroid papillary carcinoma;    Octreotide;   

DOI  :  10.1507/endocrj.47.731

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(22)Cited-By(4)A 27-year-old woman who presented with a left thyroid nodule was found to have hyperthyroidism caused by a syndrome of inappropriate secretion of TSH. The levels of free T3, free T4 and TSH were 9.50pg/mL, 4.05ng/dL and 2.16μU/mL, respectively. Magnetic resonance imaging of the head revealed a pituitary macroadenoma. The TSH response to TRH stimulation was normal and responses of other anterior pituitary hormones to stimulation tests were also normally preserved. Administration of octreotide with iodine successfully reversed hyperthyroidism prior to total resection of pituitary adenoma, which was followed by hemithyroidectomy of the left thyroid five months later. Histologically, the resected pituitary adenoma was a TSH-producing adenoma (TSH-oma) and the thyroid nodule was a papillary adenocarcinoma. Serum TSH diminished to undetectable levels immediately following pituitary adenomectomy but gradually normalized over nine months. Coexistence of a TSH-oma with thyroid cancer is very rare and only two similar cases have previously been documented. This combination raises the possibility that TSH may be involved in tumorigenesis in the thyroid gland.

【 授权许可】

Unknown