Case Report

Concomitant Graves Hyperthyroidism with Thyrotrophin-Secreting Pituitary Adenoma

Authors: Ming-Tsang Lee, MD, Chih-Yuan Wang, MD


The relationship of autoimmune thyroid disease and TSH-producing pituitary tumor is rarely found. We report two patients with hyperthyroidism, a 27-year-old man and a 28-year-old woman, who were diagnosed with Graves hyperthyroidism with elevated free thyroxine (FT4), suppressed TSH and positive thyrotropin receptor autoantibodies. After treatment with antithyroid drugs, FT4 did not return to normal, and serum TSH levels were found to be above-normal range. Pituitary tumors were subsequently found via pituitary magnetic resonance imaging (MRI). We suggest that Graves hyperthyroidism concomitant with TSH-producing pituitary tumor be kept in mind, as it may confuse the therapeutic course of hyperthyroidism and make it more complicated.

Key Points

* A relationship between autoimmune thyroid disease and TSH-producing pituitary tumor is rare.

* Two patients with concomitant Graves hyperthyroidism and pituitary tumors found during a therapeutic course of antithyroid medication are presented.

* Graves hyperthyroidism concomitant with TSH-producing pituitary tumors should be kept in mind, as it may complicate the therapeutic course of hyperthyroidism.

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