Refractory Transposing Hyperthyroid Disorder Inducing Tsh-secreting Pituitary Adenoma: A Case Report and Literature Review

Introduction: TSH-secreting pituitary adenomas (TSH-sPAs) or thyrotropinomas are very rare forms of pituitary adenomas (PAs). Although several authors have presented single cases or case series on this occurrence, only few authors have indicated that hyperthyroidism heralded the pathogenesis of TSH-sPA. We also present a case of refractory transposing hyperthyroid disorder inducing TSH-sPA. Case Presentation: We present a 47-year-old woman with 20 years’ history hyperthyroidism and a visible anterior neck swelling with normal TSH. She was put on anti-thyroid medications that transposed her hyperthyroid state to hypothyroid state with elevated TSH and a pituitary adenoma (PA). The PA was surgically excised via transsphenoidal approach. Conclusion: Hyperthyroidism or anti-thyroid medications could be responsible for the trigger of a feedback mechanism that led to over-secretion of TSH and subsequently the development of PA.