Pituitary thyrotroph hyperplasia mimicking prolactin-secreting adenoma

Khalil, Aly B; Kovács, Kálmán; Sima, Anders A. F.; Burrow, Gerard N.; Horváth, Éva

doi:10.1007/bf03351025

Cited by 41 publications

(22 citation statements)

References 20 publications

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“…Furthermore, the physiologic increase in the size of pituitary gland during puberty may be observed causing confusion with pituitary adenoma. [4] and also in children as recently reported [5]. centile, then continued to increase along the 50th centile.…”

Section: ) Introductionsupporting

confidence: 70%

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Secondary Pituitary Hyperplasia Induced by Hashimoto's Thyroiditis Related Hypothyroidism: A Case Report

Kim

Kwon

et al. 2010

J Korean Endocr Soc

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Pituitary hyperplasia associated with untreated primary hypothyroidism in children is a rare condition. There are only a few reports on this condition in children, and especially when pituitary hyperplasia is accompanied with Hashimoto thyroiditis and growth arrest. Here, we describe an unusual association of pituitary hyperplasia with hypothyroidism and growth retardation, and this was all caused by Hashimoto thyroiditis. Hormonal testing showed a low thyroxine level and a high thyroid stimulating hormone level, elevated anti-thyroglobulin, low growth hormone levels and prepubertal levels of gonadotropins. A large intrasellar mass expanding beyond the sella turcica was detected on magnetic resonance imaging (MRI). Homogeneous contrast enhancement of mass highly suggested that it was a pituitary hyperplasia rather than a pituitary tumor. Therapy with L-thyroxine resulted in rapid improvement of the clinical signs, including renewed growth, normalization of the hormone levels and resolution of the pituitary hyperplasia on MRI within 90 days. In children, prolonged unrecognized primary hypothyroidism might be accompanied by growth deficiency and pubertal disharmony.

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Section: ) Introductionsupporting

confidence: 70%

“…These pituitary adenomas tend to respond well to medical treatment and can usually be diagnosed on the basis of biochemical results. Cases of superfluous surgical interventions without full endocrinological evaluation have been previously described [4,5,19].…”

Section: Discussionmentioning

confidence: 99%

Secondary Pituitary Hyperplasia Induced by Hashimoto's Thyroiditis Related Hypothyroidism: A Case Report

Kim

Kwon

et al. 2010

J Korean Endocr Soc

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“…These pituitary adenomata respond well to medical treatment and can usually be diagnosed on biochemical grounds. Cases of unnecessary surgical interventions without full endocrine evaluation have been described [12, 13, 14]. …”

Section: Discussionmentioning

confidence: 99%

“…Cranial imaging demonstrates a pituitary mass, which can lead to confusion with a primary pituitary pathology. The enlargement normalises after appropriate thyroxine replacement; however, neurosurgery for a presumed primary pituitary tumour has been unnecessarily performed in cases of secondary pituitary enlargement in adults [12, 13]and in children as recently reported [14]. …”

Section: Introductionmentioning

confidence: 99%

Primary Hypothyroidism in a Child Mimicking a Pituitary Macroadenoma

Hopper¹,

Albanese²

2005

Horm Res Paediatr

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We report the case of an 11-year-old girl with primary autoimmune hypothyroidism causing secondary pituitary enlargement. She presented with headaches and a pituitary mass on MRI thought to be due to a pituitary macroadenoma. Resolution of the pituitary mass and symptoms occurred with thyroxine therapy. It is mandatory to rule out primary hypothyroidism as a cause of pituitary enlargement before surgery is considered.

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“…Some types of the pituitary hyperplasia -e.g. thyrotrophs in primary mixedema -could be largely enough to compress adjacent structures and mimic a neoplasic process, and when hyperplasia is prolonged it may progress to adenoma, at least in rodents (10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Reticular fibers network discriminates between normal hypophysis and pituitary adenomas

Ceauşu¹

2010

Acta Endo (Buc)

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Background. Usually, silver stain is needed to differentiate between normal or hyperplastic hypophysis and pituitary adenomas. Many papers reported the lack of reticular fibers network as mandatory for pituitary adenoma diagnosis.Aim. Differences between the architecture of reticular fibers in normal pituitary and pituitary adenomas.Methods. Gordon-Sweet silver staining of pituitary specimens, prelevated during pituitary surgery performed in 138 patients with the endocrine and imagistic diagnosis of pituitary macro-adenomas.Results. Pituitary specimens of pituitary adenomas was confirmed in 133 cases; 3 specimens were with normal pituitary tissue, 1 with pituitary hyperplasia, 1 with pituitary apoplexy. Twelve of 133 pituitary adenomas specimens were associated also with normal pituitary tissue. There was a loss of acinar network of reticular fibres in 115 cases, but the present study describes the persistence of reticular fibers networks in 18 (13.53%) of 133 pituitary adenomas. We identified five distribution patterns of remanent reticular fibers network in pituitary adenomas using silver staining.Conclusion. Persistence of reticular fibers in a small number of pituitary adenomas could be a possible pitfall in the discrimination between the normal hypophysis and pituitary adenoma.

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Pituitary thyrotroph hyperplasia mimicking prolactin-secreting adenoma

Cited by 41 publications

References 20 publications

Secondary Pituitary Hyperplasia Induced by Hashimoto's Thyroiditis Related Hypothyroidism: A Case Report

Secondary Pituitary Hyperplasia Induced by Hashimoto's Thyroiditis Related Hypothyroidism: A Case Report

Primary Hypothyroidism in a Child Mimicking a Pituitary Macroadenoma

Reticular fibers network discriminates between normal hypophysis and pituitary adenomas

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