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一名严重甲状腺功能减退患者的促甲状腺激素（TSH）分泌性腺瘤：甲状腺素替代治疗降低了TSH水平和肿瘤大小。

A Thyroid-stimulating Hormone (TSH) Producing Adenoma in a Patient with Severe Hypothyroidism: Thyroxine Replacement Reduced the TSH Level and Tumor Size.

作者信息

Arimura Hiroshi, Askoro Rofat, Fujio Shingo, Ummah Fauziah C, Takajo Tomoko, Nagano Yushi, Nishio Yoshihiko, Arita Kazunori

机构信息

Department of Diabetes and Endocrine Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima, Japan.

Pituitary Disorders Center, Kagoshima University Hospital, Kagoshima, Kagoshima, Japan.

出版信息

NMC Case Rep J. 2019 Dec 18;7(1):17-21. doi: 10.2176/nmccrj.cr.2018-0323. eCollection 2020 Jan.

DOI:10.2176/nmccrj.cr.2018-0323
PMID:31938677
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6957777/
Abstract

We treated an extremely rare thyroid-stimulating hormone (TSH)-producing pituitary adenoma in a 63-year-old woman with severe hypothyroidism due to autoimmune thyroiditis. She was presented with dizziness and fatigue. The blood level of TSH, prolactin, and fT4 was 288.2 μIU/mL, 72.9 ng/mL, and 0.24 ng/dL, respectively. Magnetic resonance imaging demonstrated a large pituitary tumor, 31 mm in height, and a normal pituitary gland. Preoperative thyroxine replacement reduced the TSH level to 2.05 μIU/mL and produced a significant reduction in the tumor volume. Histopathologically, the surgically removed tumor was a TSH-producing pituitary adenoma.

摘要

我们治疗了一名63岁患有自身免疫性甲状腺炎导致严重甲状腺功能减退的女性患者，她患有极其罕见的分泌促甲状腺激素（TSH）的垂体腺瘤。她出现头晕和疲劳症状。促甲状腺激素、催乳素和游离甲状腺素4的血液水平分别为288.2μIU/mL、72.9ng/mL和0.24ng/dL。磁共振成像显示一个大的垂体肿瘤，高31mm，垂体腺正常。术前甲状腺素替代治疗将促甲状腺激素水平降至2.05μIU/mL，并使肿瘤体积显著缩小。组织病理学检查显示，手术切除的肿瘤是分泌促甲状腺激素的垂体腺瘤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa07/6957777/915556c0afee/nmccrj-7-17-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa07/6957777/4cfa139609e1/nmccrj-7-17-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa07/6957777/0b3f499f71d8/nmccrj-7-17-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa07/6957777/2c654bdbaa9f/nmccrj-7-17-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa07/6957777/915556c0afee/nmccrj-7-17-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa07/6957777/4cfa139609e1/nmccrj-7-17-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa07/6957777/0b3f499f71d8/nmccrj-7-17-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa07/6957777/2c654bdbaa9f/nmccrj-7-17-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa07/6957777/915556c0afee/nmccrj-7-17-g004.jpg

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