Background. The thyrotropin-secreting adenomas are very rare and even more rare when they simultaneously coexist with thyroid carcinoma. So far, only sixteen cases have been reported in the literature. Here, we present a unique case of successful management of a concurrent case of thyrotropin-prolactinoma with papillary thyroid carcinoma. Case Presentation. A 50-year-old Moroccan woman underwent a total thyroidectomy and complementary totalization by iratherapy for papillary thyroid carcinoma, who presented persistence of an inappropriate secretion of the thyroid-stimulating hormone (TSH > 4 mUI/L) despite of levothyroxine suppressive therapy (300 μg/d). After eliminating noncompliance, interfering medicines, and thyroid malabsorption, a pituitary adenoma (12 mm) was documented at magnetic resonance imaging. The patient has had transsphenoidal pituitary adenomectomy with histology confirming a thyrotropin-prolactin-secreting adenoma. After surgery and lanreotide treatment failures, we noted a complete response (TSH < 0.5) with cabergoline treatment (3 mg/week). Conclusion. The unusual association of thyroid adenocarcinoma and TSHoma enriches the hypothesis of a potential link between thyrotropic hypersecretion and thyroid carcinogenesis. Our case also illustrates the difficulty of monitoring thyroid carcinoma in nonremission of a TSHoma.
Le léiomyosarcome de la veine cave inférieure est une tumeur maligne rare développée aux dépens des cellules musculaires lisses de la paroi vasculaire. L'imagerie radiologique par tomodensitométrie ou résonance magnétique nucléaire est un élément important au diagnostic et au bilan d'extension tumorale. Le traitement est chirurgical. Nous illustrons l'apport de l'imagerie à travers un cas de léiomyosarcome révélé par des épigastralgies paroxystiques, dont le diagnostique était orienté par la TDM, et confirmé par l’étude histologique. L’évolution était favorable. Après 2 ans de recul, la patiente était indemne de toute récidive tumorale.
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