Abstract | RATIONALE: PATIENT CONCERNS: Case 1: A 35-year-old man presented to the local clinic with a 2-year history of fatigue, puffiness in the bilateral lower extremities and facial region, and coarseness of facial features. Additionally, his relatives also supplemented that he suffered from hypomnesis and hypophrenia.Case 2: A 56-year-old, postmenopausal woman presented to the local clinic with fatigue, dry skin, and sluggishness. DIAGNOSES: INTERVENTIONS: A microscopical tumorectomy was performed when the two patients were admitted to our hospital. Thyroid hormone replacement therapy ( thyroxine 50 μg/day) was prescribed after microsurgery. OUTCOMES: After 32 months (Case 1) or 43 months (Case 2) follow-up respectively, there was no recurrence, and the symptoms were completely relieved. LESSONS: Pituitary hyperplasia caused by primary hypothyroidism responds well to thyroid hormone replacement therapy. It is worth noting that repeated detection of serum T3, T4, and thyroid-stimulating hormone (TSH) should be performed 3 months after replacement therapy. If the results showed that TSH level decreased partly, while thyroid function did not improve significantly, long-term increased secretion of pituitary TSH adenoma should be considered. And microsurgical resection via a transsphenoidal approach could be ordered. If the optic nerve or optic chiasm were pressed by the adenoma, microsurgery should be performed to relieve the pressure immediately. And then, thyroxine tablet substitute therapy should be performed after surgery.
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Authors | Jianyang Du, Hang Ji, Jiaqi Jin, Shuai Gao, Xiuwei Yan, Shaoshan Hu |
Journal | Medicine
(Medicine (Baltimore))
Vol. 99
Issue 8
Pg. e19222
(Feb 2020)
ISSN: 1536-5964 [Electronic] United States |
PMID | 32080117
(Publication Type: Case Reports, Journal Article)
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Chemical References |
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Topics |
- Adenoma
(etiology, surgery)
- Adult
- Female
- Humans
- Hypothyroidism
(complications)
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Pituitary Neoplasms
(etiology, surgery)
- Thyrotropin
(blood)
- Thyroxine
(blood)
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