{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T20:08:37Z","timestamp":1790366917467,"version":"4.1.0"},"reference-count":6,"publisher":"The Endocrine Society","issue":"4","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"vor","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>A 65-year-old man with a history of thyrotropin (TSH)-secreting pituitary adenoma presented with progressive spinal pain 7 years after diagnosis. Laboratory examinations revealed hyperthyroidism with markedly elevated TSH 28.5\u2005mIU\/mL (reference range, 0.3-5.0\u2005mIU\/mL) and a large pituitary tumor. Despite 3 transsphenoidal surgeries and long-term octreotide therapy, the tumor gradually enlarged. Radioiodine (RAI) therapy using iodine-131 (I-131; hereafter \u201cI-131 therapy\u201d) was administered for refractory thyrotoxicosis, after which thyroid hormone levels normalized but TSH rose dramatically (&amp;gt;500\u2005mIU\/mL). Subsequently, magnetic resonance imaging (MRI) revealed multiple spinal metastases. Biopsy of a vertebral lesion demonstrated chromophobic adenocarcinoma with positive TSH immunostaining, confirming metastatic TSH-secreting pituitary carcinoma. Palliative spinal irradiation and pamidronate temporarily relieved symptoms, but the patient died of pneumonia 8 years after onset. Autopsy revealed widespread bone metastases without any other primary malignancy. This case illustrates the malignant transformation of a TSH-secreting pituitary adenoma into carcinoma with distant bone metastases and suggests that I-131 therapy may have accelerated tumor progression. Early recognition of central hyperthyroidism and avoidance of I-131 therapy before pituitary-directed therapy are crucial to prevent treatment-related tumor exacerbation.<\/jats:p>","DOI":"10.1210\/jcemcr\/luaf332","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:51:15Z","timestamp":1765889475000},"source":"Crossref","is-referenced-by-count":1,"title":["A Case of Thyrotropin-Secreting Pituitary Carcinoma With Bone Metastases"],"prefix":"10.1210","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0607-5834","authenticated-orcid":false,"given":"Tadasu","family":"Nagaoka","sequence":"first","affiliation":[{"name":"Department of Diabetes and Endocrinology, Public Central Hospital of Matto Ishikawa , Hakusan, Ishikawa 924-8588 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyoshi","family":"Takagawa","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, University of Toyama , Toyama 930-0194 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunihiko","family":"Yokoyama","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Public Central Hospital of Matto Ishikawa , Hakusan, Ishikawa 924-8588 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4393-3244","authenticated-orcid":false,"given":"Toshinari","family":"Takamura","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Kanazawa University Graduate School of Medical Sciences , Kanazawa, Ishikawa 920-8640 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"issue":"5","key":"2026040203535636600_luaf332-B1","doi-asserted-by":"crossref","first-page":"3089","DOI":"10.1210\/jc.2004-2231","article-title":"Clinical review: diagnosis and management of pituitary carcinomas","volume":"90","author":"Kaltsas","year":"2005","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2026040203535636600_luaf332-B2","first-page":"529","article-title":"Thyrotropin-secreting pituitary carcinoma","volume":"76","author":"Mixson","year":"1993","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"2026040203535636600_luaf332-B3","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1111\/j.1365-2265.2011.04288.x","article-title":"TSH-secreting pituitary carcinoma with intrathecal drop metastases","volume":"76","author":"Lee","year":"2012","journal-title":"Clin Endocrinol"},{"issue":"5","key":"2026040203535636600_luaf332-B4","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1530\/eje.1.02141","article-title":"A pituitary carcinoma secreting TSH and prolactin: a non-secreting adenoma gone awry","volume":"154","author":"Brown","year":"2006","journal-title":"Eur J Endocrinol"},{"issue":"2","key":"2026040203535636600_luaf332-B5","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1210\/jcem.84.2.5505","article-title":"Thyrotropin-secreting pituitary tumors: diagnostic criteria, thyroid hormone sensitivity, and treatment outcome in 25 patients followed at the NIH","volume":"84","author":"Brucker-Davis","year":"1999","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2026040203535636600_luaf332-B6","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1136\/jnnp.2006.095661","article-title":"Ablative thyroid treatment for thyrotoxicosis due to thyrotropin-producing pituitary tumours","volume":"78","author":"Daousi","year":"2007","journal-title":"J Neurol Neurosurg Psychiatry"}],"container-title":["JCEM Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/4\/4\/luaf332\/67720727\/luaf332.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/4\/4\/luaf332\/67720727\/luaf332.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T07:54:04Z","timestamp":1775116444000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcemcr\/article\/doi\/10.1210\/jcemcr\/luaf332\/8571949"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,19]]},"references-count":6,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,3,19]]}},"URL":"https:\/\/doi.org\/10.1210\/jcemcr\/luaf332","relation":{},"ISSN":["2755-1520"],"issn-type":[{"value":"2755-1520","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,4]]},"published":{"date-parts":[[2026,3,19]]},"article-number":"luaf332"}}