Many malignancies may present with metastases to the pituitary gland. The a
ssociation of thyroid carcinoma with pituitary metastases is, however, very
rare. This report describes two patients in whom metastases from a papilla
ry thyroid carcinoma to the pituitary gland resulted in panhypopituitarism
with blunted endogenous thyrotropin (TSH) production following withdrawal o
f levothyroxine. Both required the use of recombinant human TSH prior to ra
dioiodine therapy. Symptoms of hypopituitarism may be difficult to distingu
ish clinically from those of hypothyroidism in the setting of levothyroxine
withdrawal. Clinicians should be aware of the clinical and biochemical man
ifestations of this rare association.