{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T22:42:34Z","timestamp":1772577754227,"version":"3.50.1"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T00:00:00Z","timestamp":1659916800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:p>Ectopic thyroid-stimulating hormone (TSH)oma located outside the sella turcica is exceedingly rare and can be associated with significant diagnostic delay. The clinical presentation depends on the anatomical location and size of the ectopic tumor and the degree of thyrotoxicosis. A 71-year-old woman presented with goiter and thyrotoxicosis. Initial investigations revealed elevated free thyroxine (fT4) and tri-iodothyronine (fT3) with inappropriately high-normal TSH. Assay interference was unlikely, pituitary magnetic resonance imaging (MRI) scan was reported as \u201cnormal,\u201d and germline sequencing was negative for thyroid hormone receptor \u00df pathogenic variants. One year later, total thyroidectomy for enlarging symptomatic goiter and suspicious nodule revealed multifocal microscopic papillary thyroid carcinoma. Six years later, she presented to an ear, nose, and throat surgeon with nasal congestion, and a sphenoid bone mass was discovered on nasoendoscopy and imaging. Ectopic TSHoma was confirmed on surgical resection, and a review of the initial pituitary MRI scan revealed the mass which had initially been missed. This is the first reported case of an ectopic TSHoma located in the sphenoid bone. Ectopic TSHoma should be considered in patients with inappropriate TSH secretion when more common differentials are excluded including thyroid hormone resistance or pituitary TSHoma.<\/jats:p>","DOI":"10.3389\/fendo.2022.961256","type":"journal-article","created":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T06:48:51Z","timestamp":1659941331000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["A patient with an ectopic sphenoid bone TSH secretory adenoma: Case report and review of the literature"],"prefix":"10.3389","volume":"13","author":[{"given":"Shejil","family":"Kumar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cun An","family":"Phang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huajing","family":"Ni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terrence","family":"Diamond","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,8,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1007\/s11102-020-01071-x","article-title":"Ectopic pituitary adenomas: clinical features, diagnostic challenges and management","volume":"23","author":"Zhu","year":"2020","journal-title":"Pituitary"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1007\/s11102-020-01057-9","article-title":"Ectopic GH-secreting pituitary adenoma of the clivus: systematic literature review of a challenging tumour","volume":"23","author":"Riccio","year":"2020","journal-title":"Pituitary"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1007\/s11102-019-00954-y","article-title":"Ectopic pituitary adenomas: common presentations of a rare entity","volume":"22","author":"Agely","year":"2019","journal-title":"Pituitary"},{"key":"B4","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1016\/j.wneu.2018.10.200","article-title":"Variability in clinical presentation and pathologic implications of ectopic pituitary tumors: Critical review of literature","volume":"122","author":"Shuman","year":"2019","journal-title":"World Neurosurg"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1089\/thy.1996.6.337","article-title":"Hyperthyroidism caused by an ectopic TSH-secreting pituitary tumor","volume":"6","author":"Cooper","year":"1996","journal-title":"Thyroid"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1530\/eje.0.1480253","article-title":"Ectopic TSH-secreting pituitary adenoma of the vomerosphenoidal junction","volume":"148","author":"Pasquini","year":"2003","journal-title":"Eur J Endocrinol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2004.10.015","article-title":"Extracranial thyroid-stimulating hormone-secreting ectopic pituitary adenoma of the nasopharynx","volume":"133","author":"Collie","year":"2005","journal-title":"Otolaryngol Head Neck Surg"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2012.0574","article-title":"Hyperthyroidism caused by an ectopic thyrotropin-secreting tumor of the nasopharynx: A case report and review of the literature","volume":"23","author":"Tong","year":"2013","journal-title":"Thyroid"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2014.07.004","article-title":"Thyroid-stimulating hormone-secreting ectopic pituitary adenoma of the nasopharynx","volume":"41","author":"Nishiike","year":"2014","journal-title":"Auris Nasus Larynx"},{"key":"B10","doi-asserted-by":"publisher","first-page":"544","DOI":"10.1186\/1471-2407-14-544","article-title":"Ectopic TSH-secreting pituitary tumor: a case report and review of prior cases","volume":"14","author":"Song","year":"2014","journal-title":"BMC Cancer"},{"key":"B11","doi-asserted-by":"publisher","first-page":"617.e613","DOI":"10.1016\/j.wneu.2016.08.062","article-title":"Ectopic suprasellar thyrotropin-secreting pituitary adenoma: Case report and literature review","volume":"95","author":"Wang","year":"2016","journal-title":"World Neurosurg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"e8912","DOI":"10.1097\/MD.0000000000008912","article-title":"Ectopic thyrotropin secreting pituitary adenoma concomitant with papillary thyroid carcinoma: Case report","volume":"96","author":"Yang","year":"2017","journal-title":"Med (Baltimore)"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-018-3638-1","article-title":"Calcified ectopic TSH-secreting pituitary adenoma mimicking craniopharyngioma: a rare case report and literature review","volume":"160","author":"Hanaoka","year":"2018","journal-title":"Acta Neurochir (Wien)"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2019.02.022","article-title":"Ectopic thyroid-stimulating hormone\u2013secreting pituitary adenoma of the nasopharynx diagnosed by gallium 68 DOTATATE positron emission Tomography\/Computed tomography","volume":"125","author":"Kim","year":"2019","journal-title":"World Neurosurg"},{"key":"B15","doi-asserted-by":"publisher","first-page":"108535","DOI":"10.1016\/j.steroids.2019.108535","article-title":"Ectopic pituitary adenoma of the TSH-secreting sphenoidal sinus with excellent response to somatostatin analogs. theory of the embryogenesis and literature review from a clinical case","volume":"154","author":"Ortiz","year":"2020","journal-title":"Steroids"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1159\/000505020","article-title":"Secondary hyperthyroidism due to an ectopic thyrotropin-secreting neuroendocrine pituitary tumor: A case report","volume":"9","author":"Trummer","year":"2020","journal-title":"Eur Thyroid J"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2021.619161","article-title":"Case report and literature review: Ectopic thyrotropin-secreting pituitary adenoma in the suprasellar region","volume":"12","author":"Li","year":"2021","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2020.00432","article-title":"The differential diagnosis of discrepant thyroid function tests: Insistent pitfalls and updated flow-chart based on a long-standing experience","volume":"11","author":"Campi","year":"2020","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B19","doi-asserted-by":"publisher","first-page":"3","DOI":"10.3343\/alm.2019.39.1.3","article-title":"Laboratory testing in thyroid conditions - pitfalls and clinical utility","volume":"39","author":"Soh","year":"2019","journal-title":"Ann Lab Med"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-19-1021","article-title":"Familial dysalbuminaemic hyperthyroxinaemia interferes with current free thyroid hormone immunoassay methods","volume":"182","author":"Khoo","year":"2020","journal-title":"Eur J Endocrinol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2021.656551","article-title":"Resistance to thyroid hormone beta: A focused review","volume":"12","author":"Pappa","year":"2021","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B22","doi-asserted-by":"publisher","first-page":"e229430","DOI":"10.1136\/bcr-2019-229430","article-title":"Challenging diagnosis of resistance to thyroid hormone in a patient with pituitary adenoma","volume":"12","author":"Carvalho Cunha","year":"2019","journal-title":"BMJ Case Rep"},{"key":"B23","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1186\/s12885-015-1352-4","article-title":"Retrospective evaluation of the incidental finding of 403 papillary thyroid microcarcinomas in 2466 patients undergoing thyroid surgery for presumed benign thyroid disease","volume":"15","author":"Slijepcevic","year":"2015","journal-title":"BMC Cancer"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23333","article-title":"Clinical and pathological characteristics of incidental and nonincidental papillary thyroid microcarcinoma in 339 patients","volume":"36","author":"Vasileiadis","year":"2014","journal-title":"Head Neck"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2012.0595","article-title":"Papillary thyroid microcarcinoma in Denmark 1996-2008: a national study of epidemiology and clinical significance","volume":"23","author":"Londero","year":"2013","journal-title":"Thyroid"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2022.961256\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T06:48:53Z","timestamp":1659941333000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2022.961256\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,8]]},"references-count":25,"alternative-id":["10.3389\/fendo.2022.961256"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2022.961256","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,8]]},"article-number":"961256"}}