TSH secreting adenoma of the pituitary gland in a female patient with undesired childlessness

Abstract

Context: TSH secreting pituitary adenomas are a very rare cause of hyperthyroidism and related clinical problems like amenorrhea. TSH elevations are often explained by hypothyroidism as in many cases only TSH levels are measured as a global marker for thyroid function. Case description: We report the case of a young woman who saw a general practitioner because of undesired childlessness. Initially misdiagnosed with hypothyroidism the definite diagnosis of a TSH secreting adenoma took five years and finally led to a successful treatment. After adenomectomy was performed the patient presented with normal thyroid function tests and menses in a regular manner. Conclusion: This case emphasizes the need for careful evaluation of rare causes of childlessness. An early MRI scan should be considered when an inadequate increase of TSH in the presence of elevated peripheral hormones is detected. Keywords: Hyperthyroidism, TSH elevation, TSH secreting pituitary adenoma, TSHoma, Amenorrhea, Prolactin, Prolactinoma, Pituitary macroadenoma, Childlessness