Hyperthyroidism in a patient with TSH-producing pituitary adenoma coexisting with thyroid papillary adenocarcinoma

Masayuki Kishida, Fumio Otsuka, Hideo Kataoka, Kazuaki Yokota, Tetsuya Oishi, Takayoshi Yamauchi, Hiroyoshi Doihara, Takashi Tamiya, Yukari Mimura, Toshio Ogura, Hirofumi Makino

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18 Citations (Scopus)


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 9.50 pg/mL, 4.05 ng/dL and 2.16 μU/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.

Original languageEnglish
Pages (from-to)731-738
Number of pages8
JournalEndocrine journal
Issue number6
Publication statusPublished - 2000


  • Hyperthyroidism
  • Octreotide
  • TSH-producing pituitary adenoma
  • Thyroid papillary carcinoma

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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