Plurihormonal (TSH-GH-prolactin Secreting) PIT-1-Positive pituitary Macroadenoma/Pituitary Neuroendocrine Tumor (PitNET) Associated with Graves' Disease: A Case Report.
GH-secreting adenoma
Graves’ disease
Pituitary Neuroendocrine Tumor (PitNET)
Plurihormonal Pit-1-positive-Pituitary Adenoma
TSH-secreting adenoma
prolactinoma
Journal
Endocrine, metabolic & immune disorders drug targets
ISSN: 2212-3873
Titre abrégé: Endocr Metab Immune Disord Drug Targets
Pays: United Arab Emirates
ID NLM: 101269157
Informations de publication
Date de publication:
2023
2023
Historique:
received:
28
03
2023
revised:
01
06
2023
accepted:
16
06
2023
medline:
21
9
2023
pubmed:
26
6
2023
entrez:
26
6
2023
Statut:
ppublish
Résumé
Differential diagnosis of primary and secondary hyperthyroidism can be challenging. Moreover, although extremely rare, the two conditions can coexist. A 58-year-old woman presented with symptoms of thyrotoxicosis, gradual changes in face shape, headache and progressive enlargement of hands and feet in the last year. When she was 46 years old, she was diagnosed with Graves' disease, and treated with 4-year methimazole therapy. Since 2016, a progressive increase of free-T4 and free-T3 with normal-TSH and positive TrAb was noticed. At biochemical examination, fT3 was 5.3pg/ml (n. v. 2.5 - 3.9 pg/ml), fT4 was 20.6 pg/ml (n.v 6-12 pg/ml), IGF1 was 698 ng/ml (57 - 240 ng/ml*), GH (basally and after OGTT), and prolactin were significantly increased; while TSH was 1.8 (n.v. 0.35-4.0 mcUI/ml). A pituitary MRI demonstrated a large sellar tumor with suprasellar extension. The patient underwent endoscopic transsphenoidal surgery. Histological examination revealed a plurihormonal (GH-PRLTSH- secreting) PIT-1-positive pituitary adenoma/pituitary neuroendocrine tumor (PitNET). At 3- month follow-up, the pituitary function was normal, and no residual tumor was detected at the MRI. We report a rare case of Graves' disease coexisting with a plurihormonal PIT-1-positive pituitary adenoma/PitNET.
Sections du résumé
BACKGROUND
BACKGROUND
Differential diagnosis of primary and secondary hyperthyroidism can be challenging. Moreover, although extremely rare, the two conditions can coexist.
CASE PRESENTATION
METHODS
A 58-year-old woman presented with symptoms of thyrotoxicosis, gradual changes in face shape, headache and progressive enlargement of hands and feet in the last year. When she was 46 years old, she was diagnosed with Graves' disease, and treated with 4-year methimazole therapy. Since 2016, a progressive increase of free-T4 and free-T3 with normal-TSH and positive TrAb was noticed.
RESULTS
RESULTS
At biochemical examination, fT3 was 5.3pg/ml (n. v. 2.5 - 3.9 pg/ml), fT4 was 20.6 pg/ml (n.v 6-12 pg/ml), IGF1 was 698 ng/ml (57 - 240 ng/ml*), GH (basally and after OGTT), and prolactin were significantly increased; while TSH was 1.8 (n.v. 0.35-4.0 mcUI/ml). A pituitary MRI demonstrated a large sellar tumor with suprasellar extension. The patient underwent endoscopic transsphenoidal surgery. Histological examination revealed a plurihormonal (GH-PRLTSH- secreting) PIT-1-positive pituitary adenoma/pituitary neuroendocrine tumor (PitNET). At 3- month follow-up, the pituitary function was normal, and no residual tumor was detected at the MRI.
CONCLUSION
CONCLUSIONS
We report a rare case of Graves' disease coexisting with a plurihormonal PIT-1-positive pituitary adenoma/PitNET.
Identifiants
pubmed: 37357515
pii: EMIDDT-EPUB-132663
doi: 10.2174/1871530323666230623161631
doi:
Substances chimiques
Prolactin
9002-62-4
Thyrotropin
9002-71-5
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
1557-1561Informations de copyright
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