Successful management of TSH-secreting adenoma misdiagnosed as hypothyroidism in 65-year-old male: A case report

一例65岁男性患者,其促甲状腺激素(TSH)分泌性腺瘤被误诊为甲状腺功能减退症,最终成功治疗:病例报告

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Abstract

INTRODUCTION: Thyrotropin-secreting adenoma (TSHoma) is a rare functional pituitary tumor, accounting for less than 3 % of all pituitary tumors, characterized by central hyperthyroidism and inappropriate TSH secretion. PRESENTATION OF CASE: We present a case of a 65-year-old man with a history of unresponsive hypothyroidism, diagnosed with a pituitary tumor through MRI and CT scans. Following partial tumor resection, histopathological examination confirmed a benign TSHoma. The patient was discharged in stable condition after three days, receiving long-term octreotide injections and propranolol without complications. DISCUSSION: TSHomas, resulting from abnormal growth of TSH-producing pituitary cells, pose diagnostic challenges and are often misdiagnosed. Trans-Sphenoidal surgery is the standard treatment, and long-acting somatostatin analogs like octreotide can effectively restore normal thyroid function in over 90 % of patients. CONCLUSION: This report emphasizes the need to consider TSHoma as a potential cause that may be initially overlooked, highlighting the diagnostic and management challenges of this rare condition.

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