Double Trouble: A Case Report of Abnormal Uterine Bleeding due to Both Central and Peripheral Pathology

A 46-year-old female came to the gynecology outpatient department with heavy and prolonged menstrual bleeding. The examination revealed a thyroid mass and tachycardia. Systemic and gynecological examinations were insignificant. Laboratory tests revealed a deranged thyroid profile which was further explored by performing magnetic resonance imaging. This revealed a functioning pituitary microadenoma producing thyroid-stimulating hormone (TSH). This entity is known as a TSHoma. Ultrasonography of the abdomen and pelvis showed increased endometrial thickness. The patient was treated with antithyroid medication and has undergone Mirena intrauterine contraceptive device insertion. The patient is planned for a hysterectomy when the thyroid profile is normalized.