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A patient with an ectopic sphenoid bone TSH secretory adenoma: Case report and review of the literature

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...

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Autores principales: Kumar, Shejil, Phang, Cun An, Ni, Huajing, Diamond, Terrence
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9393506/
https://www.ncbi.nlm.nih.gov/pubmed/36004344
http://dx.doi.org/10.3389/fendo.2022.961256
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author Kumar, Shejil
Phang, Cun An
Ni, Huajing
Diamond, Terrence
author_facet Kumar, Shejil
Phang, Cun An
Ni, Huajing
Diamond, Terrence
author_sort Kumar, Shejil
collection PubMed
description 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 “normal,” and germline sequencing was negative for thyroid hormone receptor ß 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.
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spelling pubmed-93935062022-08-23 A patient with an ectopic sphenoid bone TSH secretory adenoma: Case report and review of the literature Kumar, Shejil Phang, Cun An Ni, Huajing Diamond, Terrence Front Endocrinol (Lausanne) Endocrinology 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 “normal,” and germline sequencing was negative for thyroid hormone receptor ß 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. Frontiers Media S.A. 2022-08-08 /pmc/articles/PMC9393506/ /pubmed/36004344 http://dx.doi.org/10.3389/fendo.2022.961256 Text en Copyright © 2022 Kumar, Phang, Ni and Diamond https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Kumar, Shejil
Phang, Cun An
Ni, Huajing
Diamond, Terrence
A patient with an ectopic sphenoid bone TSH secretory adenoma: Case report and review of the literature
title A patient with an ectopic sphenoid bone TSH secretory adenoma: Case report and review of the literature
title_full A patient with an ectopic sphenoid bone TSH secretory adenoma: Case report and review of the literature
title_fullStr A patient with an ectopic sphenoid bone TSH secretory adenoma: Case report and review of the literature
title_full_unstemmed A patient with an ectopic sphenoid bone TSH secretory adenoma: Case report and review of the literature
title_short A patient with an ectopic sphenoid bone TSH secretory adenoma: Case report and review of the literature
title_sort patient with an ectopic sphenoid bone tsh secretory adenoma: case report and review of the literature
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9393506/
https://www.ncbi.nlm.nih.gov/pubmed/36004344
http://dx.doi.org/10.3389/fendo.2022.961256
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