Author/Authors :
Aksoy, Duygu Yazgan Department of Internal Medicine - Section of Endocrinology and Metabolism - Hacettepe University, Ankara , Gedik, Arzu Department of Internal Medicine - Section of Endocrinology and Metabolism - Dokuz Eylul University - Izmir, Turkey , Cinar, Nese Department of Internal Medicine - Section of Endocrinology and Metabolism - Hacettepe University, Ankara , Soylemezoglu, Figen Departments of Pathology - Hacettepe University, Ankara , Berker, Mustafa Medical School - Hacettepe University, Ankara , Gurlek, Omer Alper Department of Internal Medicine - Section of Endocrinology and Metabolism - Hacettepe University, Ankara
Abstract :
Thyroid disorders are frequently encountered. The diagnosis is straightforward unless clinical or laboratory findings are inconclusive
and/or perplexing. Hyperthyroidism due to a thyrotropin-secreting pituitary adenoma rarely occurs and symptoms due to thyroid
hormone excess are subtle. The presentation of the disease becomes unusual when co-secretion of other hormones with thyrotropin
or concomitant thyroid parenchymal pathology exist. We present the case of a 63-year-old female patient with thyrotropinoma
co-secreting growth hormone and multinodular goiter. She developed hyperthyroidism first due to thyrotropinoma and later due to
a toxic nodule. Herein, we discuss the diagnostic and therapeutic challenges of hyperthyroidism with atypical presentation.
Keywords :
Central hyperthyroidism , thyrotropinoma (TSHoma) , TSH-secreting adenoma , toxic goiter , toxic nodular goiter
