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Scholars Journal of Applied Medical Sciences | Volume-3 | Issue-03
“Macro-adenoma or Pituitary Hyperplasia”: How to Make a Difference and don’t Operate? About Case Report
Sanae Elhadri, Faycal Elguendouz, Hicham Baïzri
Published: May 26, 2015 |
122
156
DOI: 10.36347/sjams.2015.v03i03.045
Pages: 1277-1279
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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.