A case of a co-secreting TSH and growth hormone pituitary adenoma presenting with a thyroid nodule. (23rd August 2018)

• Record Type: Journal Article
• Authors: Adams, Laura Hamilton; Adams, Derick
• Is Part Of: Endocrinology, diabetes & metabolism case reports. (2018)
• Publication Date: 2018-08-23
• Subjects: Adult -- Female -- White -- United States; Pituitary -- Pituitary -- TSH -- GH -- Thyroxine (T4) -- IGF1 -- IGF2 -- LH -- FSH -- Prolactin -- Cortisol -- Plurihormonal pituitary adenoma -- Thyroid nodule -- Acromegaly -- Diabetes insipidus - neurogenic/central -- Hypogonadism -- Hyperthyroidism; Thyroid nodule -- Hypogonadism -- Neck mass -- Neck pain/discomfort -- Diabetes insipidus -- Headache -- Hyperthyroidism -- Polyuria -- Face - coarse features -- Hands - enlargement -- Feet - increased size -- Amenorrhoea -- Soft tissue swelling -- Cortisol (9am) -- Prolactin -- MRI -- IGF1 -- IGF2 -- FT4 -- TSH -- Plasma osmolality -- Urine osmolality -- Thyroid ultrasonography -- LH -- FSH -- Sodium -- ACTH stimulation -- Thyroid function -- GH -- Histopathology -- Transsphenoidal surgery -- Resection of tumour -- Gamma knife radiosurgery -- Desmopressin -- Hydrocortisone -- Glucocorticoids; Unique/unexpected symptoms or presentations of a disease -- August -- 2018; Endocrinology -- Periodicals; Diabetes -- Periodicals; Diabetes Mellitus; Endocrinology; Diabetes; Endocrinology; Case Reports; Periodicals; Periodicals; 616.4
• DOI: 10.1530/EDM-18-0067
• Languages: English
• ISSNs: 2052-0573

Abstract

Summary: Co-secreting TSH and growth hormone pituitary adenomas are rare. We present a case of a 55-year-old woman who presented with symptoms of neck fullness. Ultrasound revealed multiple thyroid nodules and examination revealed several clinical features of acromegaly. She was found to have a co-secreting TSH and growth hormone pituitary macroadenoma. She underwent surgical resection followed by gamma knife radiation, which resulted in complete remission of her TSH and GH-secreting adenoma. Learning points: TSH-secreting pituitary adenomas are rare and about one-third co-secrete other hormones. Thyroid nodules are common in acromegaly and can be the presenting sign of a growth hormone-secreting pituitary adenoma. In the workup of acromegaly, assessment of other pituitary hormones is essential, even in the absence of symptoms of other pituitary hormone dysfunction. Complete remission of co-secreting GH and TSH pituitary macroadenomas is possible with surgery and radiation alone.