Regression Of Pseudo Hypophysial Mass By Medical Therapy In A Patient With Hypothyroidism And Galactore

Yıl 2007, Cilt: 9 Sayı: 3, 44 - 47, 01.12.2007

Alptekin Tosun Salih Tosun²

Öz

amenhorrea and galactorea had investigated. Prolactin and TSH levels were increased in our patient. Ultrasonographic examination revealed thyroiditis. CT examination revealed expansion on superior contour of gland and MRI showed increased size and contrast material fixation. After medical treatment hormone levels and gland signal intensity on MRI back to normal. Hypothyroidism secondary thyroiditis resulted cell hyperplasia and showed pseudoadenoma on radiological examination. In conclusion, on patients with primary hypothyroidism and hyperprolactinemia although hypophysial gland dimensions increased, hormone theraphy have to applied primary before surgery or bromocryptine therapy and pursued by clinical, laboratory and radiological. Therefore medical treatment have considered in this disease

Anahtar Kelimeler

Hypothyroidism, hyperprolactinemia, galactorea, MRI

Hipotiroidizm Ve Galaktoreli Bir Olguda Yalanci Hipofiz Kitlesinin Medikal Tedavi Ile Regresyonu

Öz

Hiperprolaktinemi, hipotiroidizm hastalarinda görülebilmektedir. 24 yasinda bayan hasta amenore ve galaktore sikayetleri nedeniyle incelemeye alindi. Hastamizda prolaktin ve TSH degerlerinde artis mevcuttu. Ultrasonografik tetkikteyse tiroiditle uyumlu bulgular izlendi. Bilgisayarli tomografide gland üst konturunda ekspansiyon ve manyetik rezonans görüntülemede (MRG) hipofiz gland boyut ve kontrast fiksasyonunda artis mevcuttu. Medikal tedavi sonrasinda hormon degerlerinde ve MRG’d e gland sinyal intensitesinde normale dönüs saptandi. Geçirilmis tiroidite sekonder gelisen hipotiroidizm hipofizde hücre hiperplazisine neden olarak radyolojik incelemede yalanci adenom izlenimi verebilmektedir. Sonuç olarak primer hipotiroidizm ve hiperprolaktinemili olgularinda hipofiz gland boyutlarinda difüz artis mevcut ise cerrahi veya bromokriptin tedavisi öncesinde tiroid hormon replasmani tedavide ilk basamak olarak uygulanmali ve klinik, laboratuar ve radyolojik olarak takip edilmelidir. Dolayisiyla medikal tedavi bu tip hastalarda yeterli olabildigi göz önünde tutulmalidir

Anahtar Kelimeler

Hipotiroidizm, hiperprolaktinemi, galaktore, manyetik rezonans görüntüleme

Kaynakça

• Shimono T, Hatabu H, Kasagi K, Miki Y
• Nishizawa S, Misaki T, et al. Rapid progression of pituitary hyperplasia in humans with primary hypothyroidism: demonstration with MR imaging. Radiology 213:383-8, 1999.
• Veldman RG, Berg G, Pincus SM, Frolich
• M, Veldhuis JD, Roelfsema RG. Increased episodic release and disorderliness of prolactin secretion in both micro- and macroprolactinomas. Eur J Endocrinol 140:192-200, 1999.
• Ozbey N, Sariyildiz E, Yilmaz E, OrhanY
• Sencer E, Molvalilar S. Primary hypothyroidism with hyperprolactinaemia and pituitary enlargement mimicking a pituitary macroadenoma. Int J Clin Pract 51:409-11, 1999.
• Armstrong MR, Douek M, Schellinger D
• Patronas NJ. Regression of pituitary macroadenoma after pituitary apoplexy: CT and MR studies. Comput Assit Tomog 15:832-4, 1991.
• Joshi AS, Woolf PD. Pituitary hyperplasia
• secondary to primary hypothyroidism: A case report and review of the literature. Pituitary 8:99-103, 2005.
• Wolansky LJ, Leavitt GD, Elias BJ, Lee HJ
• Dasmahapatra A, Byme W. MRI of pituitary hyperplasia in hypothyroidism. Neuroradiology 38:50-2, 1996.
• Ashley WW, Ojemann JG, Park TS
• Wippold FJ. Primary hypothyroidism in a 12-year-old girl with a suprasellar pituitary mass: rapid regression after thyroid replacement theraphy: case report. J Neurosurg 102:413-6, 2005.
• Khawaja NM, Taher BM, Barham ME
• Naser AA, Hadidy AM, Ahmad AT, et al. Pituitary enlargement in patients with primary hypothyroidism. Endocr Pract 12:29-34, 2006.