{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T13:53:18Z","timestamp":1753883598722,"version":"3.41.2"},"reference-count":8,"publisher":"The Endocrine Society","issue":"5","license":[{"start":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T00:00:00Z","timestamp":1744329600000},"content-version":"vor","delay-in-days":15,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Thyroid-stimulating hormone (TSH; thyrotropin) adenoma is a rare pituitary tumor that can be missed due to its subtle symptoms. We are reporting a 67-year-old man with history of ventricular fibrillation on amiodarone who presented with acute headache and right third cranial nerve palsy. His computed tomography (CT) scan revealed a 2.2-cm suprasellar mass, consistent with pituitary apoplexy, and he underwent pituitary tumor resection. Preoperational hormonal workup revealed TSH 0.25\u2005mIU\/mL (0.25\u2005IU\/L) (normal reference range: 0.35-4.94\u2005mIU\/mL; 0.35-4.94\u2005IU\/L), free thyroxine (T4) 3.17\u2005ng\/dL (40.80\u2005pmol\/L) (normal reference range: 0.7-1.48\u2005ng\/dL; 9.78-19.05\u2005pmol\/L), and total triiodothyronine (T3) 91\u2005ng\/dL (140\u2005nmol\/L) (normal reference range: 58-159\u2005ng\/dL; 89-244\u2005nmol\/L). Initial differential diagnoses included TSH-producing pituitary adenoma (TSH-oma) and amiodarone-induced thyrotoxicosis. His free T4 declined significantly postoperatively, favoring a TSH-oma diagnosis. The pathology report showed a TSH and growth hormone (GH) cosecreting adenoma. Furthermore, he had a normal thyroid uptake scan, as well as negative thyroid antibodies, making primary thyroid diseases less likely. A high free T4 with normal TSH 3 years ago, prior to the start of amiodarone, suggested a long disease duration. This case demonstrates challenges in diagnosing TSH-oma, especially in patients with normal TSH and concurrent amiodarone use.<\/jats:p>","DOI":"10.1210\/jcemcr\/luaf063","type":"journal-article","created":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T09:23:56Z","timestamp":1744363436000},"source":"Crossref","is-referenced-by-count":0,"title":["Thyroid-Stimulating Hormone\/Growth Hormone Cosecreting Pituitary Adenoma With Normal Thyroid-Stimulating Hormone Level"],"prefix":"10.1210","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7677-6556","authenticated-orcid":false,"given":"Feyza","family":"Erenler","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center , Boston, MA 02111 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Katcher","sequence":"additional","affiliation":[{"name":"Tufts University School of Medicine , Boston, MA 02111 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Van","family":"Phan","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center , Boston, MA 02111 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Knarik","family":"Arkun","sequence":"additional","affiliation":[{"name":"Department of Pathology, Tufts Medical Center , Boston, MA 02111 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1077-8062","authenticated-orcid":false,"given":"Mina G","family":"Safain","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tufts Medical Center , Boston, MA 02111 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2025,4,11]]},"reference":[{"volume-title":"Endotext [Internet]","author":"Beck-Peccoz","key":"2025041110180036000_luaf063-B1"},{"issue":"1","key":"2025041110180036000_luaf063-B2","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1186\/s12902-021-00839-x","article-title":"A challenging TSH\/GH co-secreting pituitary adenoma with concomitant thyroid cancer; a case report and literature review","volume":"21","author":"Yoon","year":"2021","journal-title":"BMC Endocr Disord"},{"issue":"2","key":"2025041110180036000_luaf063-B3","doi-asserted-by":"crossref","first-page":"R65","DOI":"10.1530\/EJE-21-0162","article-title":"ENDOCRINE TUMOURS: thyrotropin-secreting pituitary adenoma: a structured review of 535 adult cases","volume":"185","author":"De Herdt","year":"2021","journal-title":"Eur J Endocrinol"},{"issue":"24","key":"2025041110180036000_luaf063-B4","doi-asserted-by":"crossref","first-page":"e11047","DOI":"10.1097\/MD.0000000000011047","article-title":"Case report of recurrent atrial fibrillation induced by thyrotropin-secreting pituitary adenoma with graves\u2019 disease","volume":"97","author":"Li","year":"2018","journal-title":"Medicine (Baltimore)"},{"issue":"8","key":"2025041110180036000_luaf063-B5","doi-asserted-by":"crossref","first-page":"177","DOI":"10.4236\/ojemd.2022.128013","article-title":"Selective pituitary resistance to thyroid hormone: clinical hyperthyroidism with high TSH on levothyroxine administration in I-131 ablated \u201cgraves disease\u201d","volume":"12","author":"Moghe","year":"2022","journal-title":"Open J Endocr Metab Dis"},{"issue":"11","key":"2025041110180036000_luaf063-B6","first-page":"1008","article-title":"Thyrotropinoma and multinodular goiter: a diagnostic challenge for hyperthyroidism","volume":"18","author":"Aksoy","year":"2013","journal-title":"J Res Med Sci"},{"issue":"4","key":"2025041110180036000_luaf063-B7","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1530\/EJE-08-0348","article-title":"The usefulness of 99mTc-sestaMIBI thyroid scan in the differential diagnosis and management of amiodarone-induced thyrotoxicosis","volume":"159","author":"Piga","year":"2008","journal-title":"Eur J Endocrinol"},{"issue":"4","key":"2025041110180036000_luaf063-B8","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1038\/s41379-018-0167-7","article-title":"GATA3 immunoreactivity expands the transcription factor profile of pituitary neuroendocrine tumors","volume":"32","author":"Mete","year":"2019","journal-title":"Mod Pathol"}],"container-title":["JCEM Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/3\/5\/luaf063\/62911486\/luaf063.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/3\/5\/luaf063\/62911486\/luaf063.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T10:27:05Z","timestamp":1744367225000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcemcr\/article\/doi\/10.1210\/jcemcr\/luaf063\/8110981"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,27]]},"references-count":8,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,3,27]]}},"URL":"https:\/\/doi.org\/10.1210\/jcemcr\/luaf063","relation":{},"ISSN":["2755-1520"],"issn-type":[{"type":"electronic","value":"2755-1520"}],"subject":[],"published-other":{"date-parts":[[2025,5]]},"published":{"date-parts":[[2025,3,27]]},"article-number":"luaf063"}}