A case of TSH-secreting pituitary adenoma with acromegaly |
Yu Jin Hah, Mi Kyung Kim, Hye Soon Kim, Ealmaan Kim, Man Bin Yim, Misun Choe, Keun Gyu Park |
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말단 비대증을 동반한 갑상선자극호르몬 분비 뇌하수체 선종 1예 |
하유진, 김미경, 김혜순, 김일만, 임만빈, 최미선, 박근규 |
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Abstract |
Growth hormone (GH) and thyrotropin (TSH)-secreting pituitary adenomas are very rare and account for only 0.5% of all pituitary adenomas. We report a case of a GH/TSH-secreting pituitary adenoma in a 53-year-old male patient. He presented with symptoms of thyrotoxicosis, clinical features of acromegaly, and diabetes mellitus. The laboratory examinations showed high serum levels of free T4, TSH, and free alpha-subunit. Additionally, serum levels of GH and insulin-like growth factor (IGF-1) were increased. GH was not suppressed below 1 μg/L by an oral 75 g glucose loading test, and TSH was not stimulated by thyrotropin-releasing hormone. A sellar MRI showed a large lobulated mass on the pituitary gland, so transcranial surgery was performed. Immunohistochemical staining showed anti-GH and anti-TSH positive tumor cells in the cytoplasm. Serum GH, IGF-1, free T4, and TSH levels normalized after surgery. |
Key Words:
Thyrotrophs; Pituitary neoplasm; Acromegaly |
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