Crésio Alves1, Ana Cláudia Alves. 1. Pediatric Endocrinology, Faculty of Medicine, Universidade Federal da Bahia, Rua Plinio Moscoso, 222/601, CEP: 40157-190, Salvador, Bahia, Brazil. cresio.alves@uol.com.br
Abstract
OBJECTS: To report a case of primary hypothyroidism associated to hyperprolactinemia mimicking a prolactin secreting adenoma. MATERIALS AND METHODS: A girl (10 years and 10 months old) was evaluated for hyperprolactinemia (prolactin: 317 ng/mL [1.9-25]). Diagnostic evaluation demonstrated free thyroxine (F-T4): 0.22 ng/dL (0.75-1.80) and thyroid-stimulating hormone (TSH): 135 UI/mL (0.3-5.0). Pituitary magnetic resonance imaging (MRI) showed an intrasellar and suprasellar mass measuring 1.9 x 1.7 x 1.7 cm, impinging on the optic chiasm. Due to the possibility of a pseudoprolactinoma caused by hyperplasia of the TSH and prolactin-producing cells, she was treated for the primary hypothyroidism with levothyroxine. After 2 months, F-T4, TSH, and prolactin returned to normal values. A new pituitary MRI, 8 months later, demonstrated a complete resolution of the pituitary mass confirming the initial suspicion of thyrotroph hyperplasia. CONCLUSION: This paper illustrates the importance of thyroid function investigation in patients with hyperprolactinemia and possible prolactinoma in order to avoid unnecessary surgery.
OBJECTS: To report a case of primary hypothyroidism associated to hyperprolactinemia mimicking a prolactin secreting adenoma. MATERIALS AND METHODS: A girl (10 years and 10 months old) was evaluated for hyperprolactinemia (prolactin: 317 ng/mL [1.9-25]). Diagnostic evaluation demonstrated free thyroxine (F-T4): 0.22 ng/dL (0.75-1.80) and thyroid-stimulating hormone (TSH): 135 UI/mL (0.3-5.0). Pituitary magnetic resonance imaging (MRI) showed an intrasellar and suprasellar mass measuring 1.9 x 1.7 x 1.7 cm, impinging on the optic chiasm. Due to the possibility of a pseudoprolactinoma caused by hyperplasia of the TSH and prolactin-producing cells, she was treated for the primary hypothyroidism with levothyroxine. After 2 months, F-T4, TSH, and prolactin returned to normal values. A new pituitary MRI, 8 months later, demonstrated a complete resolution of the pituitary mass confirming the initial suspicion of thyrotroph hyperplasia. CONCLUSION: This paper illustrates the importance of thyroid function investigation in patients with hyperprolactinemia and possible prolactinoma in order to avoid unnecessary surgery.
Authors: Mark Jentoft; Bernd W Scheithauer; Olga Moshkin; Eva Horvath; Phillip C Collins; Luis V Syro; Kalman Kovacs Journal: Endocr Pathol Date: 2012-06 Impact factor: 3.943
Authors: Mark E Jentoft; Robert Y Osamura; Kalman Kovacs; Ricardo V Lloyd; Bernd W Scheithauer Journal: Virchows Arch Date: 2012-07-03 Impact factor: 4.064