Journal of Clinical Endocrinology & Metabolism, Vol 53, 338-343, Copyright © 1981 by Endocrine Society

ARTICLES

Thyrotoxicosis and a thyrotropin-secreting pituitary tumor causing unilateral exophthalmos

JG Yovos, JM Falko, TM O'Dorisio, WB Malarkey, S Cataland and CC Capen

Hyperthyroidism due to a TSH-secreting pituitary tumor has been noted by a number of investigators. We describe a unique case in which a 17- yr-old female presented with clinical hyperthyroidism, a goiter, and unilateral exophthalmos. Serum T4, free T4, and T3 (RIA) were consistently elevated along with elevated TSH levels (range, 10-100 microunits/ml). Skull x-rays and computed tomography scan revealed a tumor invading the right orbit. Other pituitary function studies were normal and LATs was undetectable. Surgery performed resulted in 70% removal of the pituitary tumor and confirmed the presence of tumor infiltration into the right orbit. TRH tests done pre- and postoperatively (patient still clinically hyperthyroid with elevated T4 and TSH levels) showed TSH and PRL responsiveness. Electron microscopy of the tumor demonstrated features typical of pituitary thyrotrophs. Monolayer cultures of pituitary cells released TSH over time into the media but did not respond to TRH stimulation. Pituitary adenoma tissue content of immunoreactive TSH was 65 microunits/g wet tissue and demonstrated immunosimilarity with human standard. We conclude that the patient had a TSH-secreting pituitary tumor responsive to TRH stimulation.

This article has been cited by other articles:

				J. M. Stanley and S. S. Najjar Hyperthyroidism Secondary to a TSH-Secreting Pituitary Adenoma In A 15-Year-Old Male Clinical Pediatrics, February 1, 1991; 30(2): 109 - 111. [PDF]