# Successful management of TSH-secreting adenoma misdiagnosed as hypothyroidism in 65-year-old male: A case report

## TL;DR

A 65-year-old man with misdiagnosed hypothyroidism was found to have a rare pituitary tumor, successfully treated with surgery and medication.

## Contribution

Highlights the diagnostic challenges and management of TSH-secreting adenomas misdiagnosed as hypothyroidism.

## Key findings

- TSHoma was confirmed via MRI, CT, and histopathology after partial tumor resection.
- Long-acting octreotide and propranolol effectively managed the condition post-surgery.
- TSHomas are rare and often misdiagnosed, requiring careful evaluation for hyperthyroidism.

## Abstract

Thyrotropin-secreting adenoma (TSHoma) is a rare functional pituitary tumor, accounting for less than 3 % of all pituitary tumors, characterized by central hyperthyroidism and inappropriate TSH secretion.

We present a case of a 65-year-old man with a history of unresponsive hypothyroidism, diagnosed with a pituitary tumor through MRI and CT scans. Following partial tumor resection, histopathological examination confirmed a benign TSHoma. The patient was discharged in stable condition after three days, receiving long-term octreotide injections and propranolol without complications.

TSHomas, resulting from abnormal growth of TSH-producing pituitary cells, pose diagnostic challenges and are often misdiagnosed. Trans-Sphenoidal surgery is the standard treatment, and long-acting somatostatin analogs like octreotide can effectively restore normal thyroid function in over 90 % of patients.

This report emphasizes the need to consider TSHoma as a potential cause that may be initially overlooked, highlighting the diagnostic and management challenges of this rare condition.

•Thyrotropin-secreting adenoma (TSHoma) is a rare functional pituitary tumor, accounting for less than 3 % of all pituitary tumors.•TSHomas, resulting from abnormal growth of TSH-producing pituitary cells, pose diagnostic challenges and are often misdiagnosed.•This report emphasizes the need to consider TSHoma as a potential cause of hyperthyroidism.

Thyrotropin-secreting adenoma (TSHoma) is a rare functional pituitary tumor, accounting for less than 3 % of all pituitary tumors.

TSHomas, resulting from abnormal growth of TSH-producing pituitary cells, pose diagnostic challenges and are often misdiagnosed.

This report emphasizes the need to consider TSHoma as a potential cause of hyperthyroidism.