A Thyroid-stimulating Hormone (TSH) Producing Adenoma in a Patient with Severe Hypothyroidism: Thyroxine Replacement Reduced the TSH Level and Tumor Size

Hiroshi Arimura; Rofat Askoro; Shingo Fujio; Fauziah C. Ummah; Tomoko Takajo; Yushi Nagano; Yoshihiko Nishio; Kazunori Arita

doi:10.2176/nmccrj.cr.2018-0323

Case Reports

A Thyroid-stimulating Hormone (TSH) Producing Adenoma in a Patient with Severe Hypothyroidism: Thyroxine Replacement Reduced the TSH Level and Tumor Size

Hiroshi Arimura, Rofat Askoro, Shingo Fujio, Fauziah C. Ummah, Tomoko Takajo, Yushi Nagano, Yoshihiko Nishio, Kazunori Arita

Author information

Hiroshi Arimura
Department of Diabetes and Endocrine Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima, Japan
Pituitary Disorders Center, Kagoshima University Hospital, Kagoshima, Kagoshima, Japan
Rofat Askoro
Faculty of Medicine, Diponegoro University, Semarang, Indonesia
Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima, Japan
Shingo Fujio
Pituitary Disorders Center, Kagoshima University Hospital, Kagoshima, Kagoshima, Japan
Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima, Japan
Fauziah C. Ummah
Faculty of Medicine, Diponegoro University, Semarang, Indonesia
Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima, Japan
Tomoko Takajo
Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima, Japan
Yushi Nagano
Pituitary Disorders Center, Kagoshima University Hospital, Kagoshima, Kagoshima, Japan
Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima, Japan
Yoshihiko Nishio
Department of Diabetes and Endocrine Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima, Japan
Kazunori Arita
Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima, Japan

Keywords: TSHoma, primary hypothyroidism, thyroxine, TRH

JOURNAL OPEN ACCESS FULL-TEXT HTML

2020 Volume 7 Issue 1 Pages 17-21

DOI https://doi.org/10.2176/nmccrj.cr.2018-0323

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Abstract

We treated an extremely rare thyroid-stimulating hormone (TSH)-producing pituitary adenoma in a 63-year-old woman with severe hypothyroidism due to autoimmune thyroiditis. She was presented with dizziness and fatigue. The blood level of TSH, prolactin, and fT4 was 288.2 μIU/mL, 72.9 ng/mL, and 0.24 ng/dL, respectively. Magnetic resonance imaging demonstrated a large pituitary tumor, 31 mm in height, and a normal pituitary gland. Preoperative thyroxine replacement reduced the TSH level to 2.05 μIU/mL and produced a significant reduction in the tumor volume. Histopathologically, the surgically removed tumor was a TSH-producing pituitary adenoma.

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