Thyrotropin-Secreting Pituitary Adenoma: A Case Report

We report a 44-year-old male with a thyrotropin (TSH)-secreting pituitary adenoma. Basal serum free triiodothyronine (FT3, 12.1pmol/l) and free thyroxine (FT4, 28 pmol/l) were increased with normal basal TSH (3.1mU/l). There was impaired TSH response to thyrotropin releasing hormone (TRH) test. Seru...

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Published inEndocrinologia Japonica Vol. 39; no. 4; pp. 413 - 419
Main Authors NAGAI, KOTARO, SAKATA, SHIGEKI, WU, CHIA-CHUAN, WADA, HIROAKI, YOKOYAMA, KAZUTOSHI, TAKADA, MITSUAKI, KASHIWAI, TAKU, TOKIMITSU, NAOKI
Format Journal Article
LanguageEnglish
Published Tokyo The Japan Endocrine Society 1992
Japan Endocrine Society
Subjects
Adult
Biological and medical sciences
Endocrinopathies
Humans
Hyperthyroidism
Hyperthyroidism - blood
Hyperthyroidism - etiology
Hypothalamus. Hypophysis. Epiphysis (diseases)
Male
Medical sciences
Non tumoral diseases. Target tissue resistance. Benign neoplasms
Pituitary adenoma
Pituitary Neoplasms - blood
Pituitary Neoplasms - complications
Pituitary Neoplasms - metabolism
Thyrotropin
Thyrotropin - blood
Thyrotropin - metabolism
Thyroxine - blood
Triiodothyronine - blood
Endocrinopathy
Case study
Human
Secretory tumor
Adenohypophyseal hormone
Hyperthyroidism
Pituitary diseases
TSH
Thyroid hormone
Pituitary gland
Adenoma
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Summary:We report a 44-year-old male with a thyrotropin (TSH)-secreting pituitary adenoma. Basal serum free triiodothyronine (FT3, 12.1pmol/l) and free thyroxine (FT4, 28 pmol/l) were increased with normal basal TSH (3.1mU/l). There was impaired TSH response to thyrotropin releasing hormone (TRH) test. Serum TSH was suppressed to 59% of the basal level after oral administration of 1.4mg 3, 3'-5-triiodothyroacetic acid (triac), whereas no suppression was observed after 75 μg daily administration of triiodothyronine (T3). Serum concentrations of a-subunit of TSH (TSH-α) and TSH-α/TSH molar ratio were high, being 1.95μg/l, and 4.4, respectively. Pituitary CT and MRI scan showed the presence of a macroadenoma in the anterior lobe of the pituitary gland. Histopathology of the excised pituitary confirmed the diagnosis of a TSH-producing adenoma. A positive correlation between TSH and FT3 (r=0.66, P<0.01) or FT4 (r=0.54, P<0.01) was observed in serial sera obtained before and after operation.
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ISSN:0013-7219
2185-6370
DOI:10.1507/endocrj1954.39.413