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Cukurova Medical Journal
Cukurova Medical Journal
Periodical of Cukurova University Faculty of Medicine
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ISSN: 0250-5150 (Print)
Language: [ Turkish ]   [ English ]  
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  » Volume 39, Issue 4
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Open Access

Case Report



A Rare Cause of Hypothyroidism: TSH’oma

Okan Bakıner, Emre Bozkırlı, A. Kürşad Özşahin, Aydan Aksöyek.

Abstract
TSH (tyrotiropin) secreting pituitary adenomas account for <1% of all hypophyseal adenomas with a prevelance of 1/1.000.000 and is a very rare reason of hyperthyroidism (TSH’oma). In these casess free t4 and free t3 levels are elevated whereas TSH levels are normal or elevated.
A 26 year old women referred to our outpatient clinic with complaints of palpitation, tremors, weight loss and dispnea for three months. Laboratory analysis showed that plasm free T3 levels (8,2 mIU/ml-normal 3,2-5,4 ) and TSH levels were high(5,7 mIU/ml, normal 0,3-4,9 mIU/ml), and free T4 level was on the upper limit (14,7 mIU/ml- normal 9-15 mIU/ml). Considering TSH depended hyperthyrodism the patient went under a magnetic resonance imaging scan (MRI) which confirmed an 11 mm lesion on hypophysis which was compatible with adenoma.The patient was diagnosed with TSH’oma and went under transnasal, transsphenoidal hypophysis surgery.
Although TSH secreting pituitary adenomas are rare causes of hyperthyrodism, advanced laboratory methods allow them to be diagnosed early and avoid unnecessary tests and time loss.

Key words: TSH’oma, Pitiutary Adenoma, Hyperthyroidism,



Nadir Bir Hipertiroidi Sebebi: TSH’oma

Özet
Hipertroidizmin en nadir görülen sebeplerinden biri prevalansı milyonda bir olan ve tüm hipofizer adenomların <%1 ‘ini oluşturan TSH (tirotropin) salgılayan pituiter adenomlardır (TSH’oma), Bu olgularda serbest T4 ve serbest T3 yüksek iken TSH normal veya yüksek bulunur.
Bizim olgumuz, 26 yaşında kadın hasta üç aydır olan çarpıntı, terleme, ellerde tremor, kilo kaybı ve nefes darlığı yakınmalarıyla kliniğimize başvurdu. Laboratuvar analizlerinde serum serbest T3 (8,2 mIU/ml- normali 3,2-5,4 ) ve TSH hormon düzeyleri yüksek (5,7 mIU/ml, normali 0,3-4,9 mIU/ml) , serbest T4 düzeyi normalin üst sınırında (14,7 mIU/ml- normali 9-15 mIU/ml) bulanan hastaya TSH bağımlı hipertiroidi düşünülerek uygulanan manyetik rezonans görüntüleme (MRI) sonucu hipofiz orta hatta 11 mm çaplı, adenomla uyumlu lezyon saptandı. TSH’oma tanısı alan hastaya nöroşirurji kliniğince transnazal-transsfenoidal hipofiz cerrahisi uygulandı.
TSH salgılayan pituiter adenomlar, hipertiroidizmin nadir sebepleri olarak karşımıza çıksalar bile, gelişmiş laboratuvar yöntemleri sayesinde erken tanınabilir ve hastaları gereksiz girişimlerden ve zaman kaybından koruyabilir.

Anahtar Kelimeler: TSH’oma, Pituiter Adenom, Hipertrodizm


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How to Cite this Article
Pubmed Style

Bakıner O, Bozkırlı E, Özşahin AK, Aksöyek A. [A Rare Cause of Hypothyroidism: TSH’oma]. Cukurova Med J. 2013; 38(3): 499-502. Turkish.



Web Style

Bakıner O, Bozkırlı E, Özşahin AK, Aksöyek A. [A Rare Cause of Hypothyroidism: TSH’oma]. www.scopemed.org/?mno=32493 [Access: July 31, 2014]. Turkish.



AMA (American Medical Association) Style

Bakıner O, Bozkırlı E, Özşahin AK, Aksöyek A. [A Rare Cause of Hypothyroidism: TSH’oma]. Cukurova Med J. 2013; 38(3): 499-502. Turkish.



Vancouver/ICMJE Style

Bakıner O, Bozkırlı E, Özşahin AK, Aksöyek A. [A Rare Cause of Hypothyroidism: TSH’oma]. Cukurova Med J. (2013), [cited July 31, 2014]; 38(3): 499-502. Turkish.



Harvard Style

Bakıner, O., Bozkırlı, E., Özşahin, A. K. & Aksöyek, A. (2013) [A Rare Cause of Hypothyroidism: TSH’oma]. Cukurova Med J, 38 (3), 499-502. Turkish.



Turabian Style

Bakıner, Okan, Emre Bozkırlı, A. Kürşad Özşahin, and Aydan Aksöyek. 2013. [A Rare Cause of Hypothyroidism: TSH’oma]. Cukurova Medical Journal, 38 (3), 499-502. Turkish.



Chicago Style

Bakıner, Okan, Emre Bozkırlı, A. Kürşad Özşahin, and Aydan Aksöyek. "[A Rare Cause of Hypothyroidism: TSH’oma]." Cukurova Medical Journal 38 (2013), 499-502. Turkish.



MLA (The Modern Language Association) Style

Bakıner, Okan, Emre Bozkırlı, A. Kürşad Özşahin, and Aydan Aksöyek. "[A Rare Cause of Hypothyroidism: TSH’oma]." Cukurova Medical Journal 38.3 (2013), 499-502. Print.Turkish.



APA (American Psychological Association) Style

Bakıner, O., Bozkırlı, E., Özşahin, A. K. & Aksöyek, A. (2013) [A Rare Cause of Hypothyroidism: TSH’oma]. Cukurova Medical Journal, 38 (3), 499-502. Turkish.







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