Hipofizer Makrodenom Tanısı Konulan Primer Hipotiroidizme Bağlı Hipofizer Hiperplazi Türkçe

Öz

Primer hipotiroidizm ile hipofizer hiperplazi, arasındaki ilişki oldukça iyi bilinse de, hipotiroid bir olgunun hipofiz hiperplazisine bağlı klİnik semptomları ile fark edilmesi nadir bir durumdur. Yazımızda baş ağrısı nedeniyle değerlendirilirken hipofizer kitle saptanan ve sonrasında hipotiroid de olduğu fark edildiğinden hipofizer hiperplazi olası tanısı ile izlenen bir olgu sunulmuştur. Olguda saptanan hipofizer kitlenin levotiroksin tedavisi ile radyolojik olarak küçüldüğü gösterilmiştir. Primer hipotiroidizme bağlı hipofizer hiperplazi ko-insidental hipofiz adenomları ile karışabilir. Radyolojik olarak hipofiz adenomu-hiperplazisi ayırımı yapmak oldukça güçtür. Ayırıcı tanıda hastanın klinik öyküsü, hormonal parametreler ve kitlenin levotiroksin replasmanı ile küçüldüğünün radyolojik olarak gösterilmesi önemlidir

Anahtar Kelimeler

• Hashimoto tiroiditi,primer hipotiroidizm,hipofizer makroadenom,hipofizer hiperplazi

Pituitary Hyperplasia Due to Primary Hypothyroidism Which Diagnosed as Pituitary Macroadenoma

Öz

Although the association of pituitary hyperplasia and primary hypothyroidism is well known, recognition of hypothyroidism due to pituitary hyperplasia is a rare occurence.We report a case of a probable pituitary hyperplasia who complaint with headache, and found to have pituitary hyperplasia during evaluation of headache and co-incidental hypothyroidism. Pituitary mass image has been shrinked with levothyroxin therapy.Pituitary hyperplasia due to primary hypothyroidism can be confused with coincidental pituitary adenomas. Radiological distinction between hyperplasia and adenomas is difficult. Patient history, hormonal parameters and radiological regression of the mass image with levothyroxin therapy are important clues in differential diagnosis

Anahtar Kelimeler

• Hashimoto thyroiditis,primary hypothyroidism,pitutiary macroadenoma,pituitary hyperplasia

Kaynakça

1. ) Joshi AS. Pituitary hyperplasia secondary to primary hypothyroidism: A Case report and Review of the literature. Pituitary 2005;8:99-103.
2. ) Horvath E, Kovacs K, Scheithauer BW. Surgical pathology of pituitary thyrotroph hyperplasia: An oxymoron? Endocr Pathol 1992;3:(Suppl.1)514–515. immunocytochemical study. Virchows Archiv B, Cell Pathol 1992;62:291–6.
3. ) Horvath E, Kovacs K, Scheithauer BW. Pituitary hyperplasia. Pituitary 1999;1:169-180.
4. ) Koller KJ, Wolff RS, Warden MK, Zoeller RT. Proc Natl Acad Sci U S A. 1987 Oct;84(20):7329-33.
5. ) Sarlis NJ, Brucker-Davis F, Doppman JL, Skarulis MC. J Clin Endocrinol Metab. 1997 Mar;82(3):808-11.
6. ) Chan AW, MacFarlane IA, Foy PM, Miles JB. Pituitary enlargement and hyperprolactinemia due to primary hypothyroidism: errors and delays in diagnosis. Br J Neurosurg 1990;4:107-12.
7. ) Wolanski LJ, Leavitt GD, Elias BJ, Lee HJ, Dasmahapatra A, Byrne W. MRI of pituitary hyperplasia in hypothyroidism. Neuroradiology 1996; 38:50-2.
8. ) Kuroiwa T, Okabe Y, Hasuo K, Yasumori K, Mizushima A, Masuda K. MR imaging of pituitary hypertrophy due to juvenile primary hypothyroidism:a case report. Clin Imaging. 1991;15:202-5.

9. ) Ahmed M, Banna M, Sakati N, Woodhouse N. Pituitary gland enlargement in primary hypothyroidism: a report of 5 cases with follow-up data.Horm Res 1989;32:188-92.
10. ) Beressi N, Cohen R, Beressi J-P, Legrand M, Iba-Zizen M-T. Modigliani E. Pseudotumoral lymphocytic hypophysistis successfully treated by corticosteroid alone: First case report. Neurosurgery 1994;35:505-8.