Thyrotrophin-producing pituitary adenomas

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✓ Hyperthyroidism due to thyrotrophin (TSH)-secreting pituitary tumors is rare. Four cases are described, with the features that allow preoperative diagnosis. In all the patients, thyroid hormone production was consistently elevated despite antithyroid therapy, and TSH levels were inappropriately elevated. All patients were treated with both surgery and irradiation. Each patient had recurrent tumor with suprasellar, intrasphenoidal, or intraorbital spread. The combination of a recurrent, aggressive tumor complicated by thyrotoxicosis makes this a complex and difficult surgical problem.

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Address reprint requests to: Stephen A. Hill, M.D., University Hospital, 410 West Tenth Avenue, Columbus, Ohio 43210.

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    Case 4. Preoperative contrast-enhanced computerized tomography scan. There is suprasellar and middle fossa extension of the tumor, especially on the right side.

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    Case 4. Enhanced computerized tomography scan prior to the second operation. There is compression of the right cerebral peduncle by the tumor.

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