オダ　ユウイチ   ODA Yuuichi   小田　侑一    所属   医学部 医学科（東京女子医科大学病院）    職種   助教
論文種別	症例報告
言語種別	英語
査読の有無	査読あり
表題	A Rare Coexistence of Thyrotropin-Secreting Pituitary Adenoma and Graves Disease.
掲載誌名	正式名：JCEM case reports 略　 称：JCEM Case Rep ISSNコード：27551520/27551520
掲載区分	国外
巻・号・頁	3(9),pp.luaf173
著者・共著者	Yuichi Oda†, Kosaku Amano*
担当区分	筆頭著者
発行年月	2025/09
概要	The coexistence of Graves disease (GD) and a thyroid-stimulating hormone (TSH)-secreting pituitary adenoma (TSHoma) is a rare and diagnostically challenging condition. In general, GD typically manifests with low TSH because of excess thyroid hormone production; contrastingly, a TSHoma causes secondary hyperthyroidism with normal or elevated TSH levels. This unusual overlap poses diagnostic and therapeutic challenges; therefore, a careful approach is required to distinguish and manage both conditions. We present the case of a 51-year-old woman with symptoms of hyperthyroidism, elevated thyroid hormones, low TSH, and positive anti-TSH receptor antibodies, which were suggestive of GD 10 years prior. After stopping thiamazole and levothyroxine because of the favorable control of thyroid function 6 months prior, the patient presented a syndrome of inappropriate secretion of TSH and magnetic resonance imaging revealed a pituitary macroadenoma; accordingly, she was diagnosed with concurrent GD and a TSHoma. Treatment involved transsphenoidal resection of the TSHoma and antithyroid medication to control GD. This case illustrates the rarity of coexisting GD and TSHoma and the diagnostic and therapeutic complexities of managing dual hyperthyroidism etiologies. Biochemical testing, antibody assessment, and imaging examination are essential for accurate and early diagnosis of the condition.
DOI	10.1210/jcemcr/luaf173
PMID	40746500