TSH-induced hyperthyroidism caused by a pituitary tumor

Paolo Beck-Peccoz, Luca Persani

Research output: Contribution to journalArticlepeer-review


Background: A 45-year-old man presented with frontal headache and visual disturbances to our clinic. For the previous 5 years, he had been receiving treatment for long-lasting mild hyperthyroidism with antithyroid therapy, but therapy had not been carefully followed. During the last 2 years he had also complained of erectile dysfunction and loss of libido. On physical examination, he had a small goiter, normal skin, no Graves' ophthalmopathy, normal BMI, and reduced testis volume and pubic hair. Investigations: Serum levels of free T3 and T4, serum prolactin, testosterone, serum gonadotropins, insulin-like growth factor 1, adrenocorticotropic hormone, and cortisol were measured. MRI scan, TSH-releasing hormone test, and T3 suppression test were carried out. Levels of pituitary glycoprotein hormone α-subunit and sex-hormone-binding protein were also measured. Diagnosis: Hyperthyroidism caused by a mixed pituitary adenoma that secretes prolactin and TSH. Management: Trans-sphenoidal resection of the pituitary tumor. After surgery, T3 suppression test failed to completely suppress TSH secretion, which suggested a persistence of residual adenomatous cells. Hyperthyroidism and hypogonadism recurred after 5 years, therefore, treatment with lanreotide was initiated, and resulted in complete resolution of signs and symptoms of the disease.

Original languageEnglish
Pages (from-to)524-528
Number of pages5
JournalNature Clinical Practice Endocrinology and Metabolism
Issue number9
Publication statusPublished - Sep 29 2006


  • Hyperthyroidism
  • Pituitary adenoma
  • Prolactin
  • Somatostatin analogs
  • TSH

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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