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Published 23 January 2009
Cite this as: BMJ Case Reports 2009 [doi:10.1136/bcr.07.2008.0541]
Copyright © 2009 by the BMJ Publishing Group Ltd.

Findings that shed new light on the possible pathogenesis of a disease or an adverse effect

Ablative thyroid treatment for thyrotoxicosis due to thyrotropin-producing pituitary tumours

C Daousi1, Patrick M Foy2, Ian A Macfarlane3

1 Clinical Sciences Centre, Lower Lane, Liverpool, L9 7AL, UK
2 The Walton Centre For Neurology & Neurosurgery, Lower Lane, Liverpool, L9 7AL, UK
3 University Hospital Aintree, Diabetes & Endocrinology Clinical Research Group, Clinical Sciences Centre, Liverpool, L9 7AL, UK

Correspondence to:
cdaousi{at}liverpool.ac.uk

SUMMARY

Thyrotropin (TSH)-secreting pituitary adenomas (TSHomas) are rare tumours. It has been suggested that thyroid surgery or radioiodine treatment should not be considered in patients with such tumours as these treatments may facilitate rapid tumour expansion. We studied the effects of thyroid ablative treatment on tumour size and thyroid status in two patients with TSHomas. Patients studied were: (1) a female with a TSHoma who declined to undergo pituitary surgery and underwent a total thyroidectomy instead and (2) a male patient who opted for radioiodine treatment for his recurrent TSHoma. Changes in tumour size on serial magnetic resonance imaging scans, and restoration of euthyroidism were studied. No marked changes in tumour size or features of aggressiveness occurred in these patients over periods of 8 and 12 years. Euthyroidism was restored and maintained in both patients. Ablative thyroid treatment can be a safe and successful option to treat TSHomas.


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