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Τετάρτη 27 Ιουνίου 2018

Pituitary 'pseudotumor: an under-recognised complication of undertreated primary hypothyroidism

Description 

A woman in her 30s with medical history notable for hypothyroidism due to Hashimoto's thyroiditis had a brain MRI ordered by her neurologist due to change in chronic headache pattern. This had an incidental finding of enlarged pituitary gland. She was referred at that time to an endocrinologist but was not seen. Eighteen months later, she presented with worsening headaches, blurry vision, weight gain and galactorrhoea. Repeat brain MRI showed a 9x10x13 mm sellar mass extending superiorly, with mass effect on optic chiasm (figure 1A). Thyroid-stimulating hormone (TSH) was 185 mIU/mL with low free T3, low free T4, normal prolactin, normal FSH and normal LH. She was then referred to a neurosurgeon and an ophthalmologist. Visual field testing initially showed mild constriction of bilateral visual fields. The neurosurgeon referred her to an endocrinologist for preoperative hormonal evaluation, but the operation date was advanced when subjective visual...



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