Macro-adenoma or Pituitary Hyperplasia”: How to Make a Difference and don’t Operate? About Case Report
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2015, Vol 3, Issue 3
Abstract
: Pituitary hyperplasia is non-neoplasic growth of at least one line of pituitary cells. The thyroid stimulating line can be affected with the waning of a device drawling hypothyroidism. It is rare and under diagnosed. Its main differential diagnosis is pituitary adenoma. We report the case of a 22 old-year patient, addressed for etiological and presurgical evaluation of a macro-adenoma. The history found a spaniomenorrhea since puberty and galactorrhea since 6 months without endocrine syndrome or endocranial tumor syndrome. Hormonal measures objective a moderate hyperprolactinemia and TSH > 100 IU / ml with a low LT4 3.24 pmol / l. Pituitary MRI reveal a pituitary tumor process engaging the optic chiasm without compressing it. The patient is put under L-Thyroxine with normalization of thyroid status and prolactin levels and a very significant regression of pituitary hyperplasia after one year of treatment. Although classical, pituitary hyperplasia secondary to hypothyroidism is rare and seldom reaches such a large size. It results from the overproduction of TRH by loss of the negative feedback exerted by thyroid hormones. The knowledge of this disease entity is paramount and should allow the clinician to distinguish an authentic tumor process to prevent the patient unnecessary surgery, heavy and not without risk. Keywords: Primary hypothyroidism, Macro-adénoma, Pituitary hyperplasia.
Authors and Affiliations
Sanae Elhadri, Faycal Elguendouz, Hicham Baïzri
Keywords
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