N. Ozbey et al., PRIMARY HYPOTHYROIDISM WITH HYPERPROLACTINEMIA AND PITUITARY ENLARGEMENT MIMICKING A PITUITARY MACROADENOMA, International journal of clinical practice, 51(6), 1997, pp. 409-411
Hyperprolactinaemia can occur in patients with hypothyroidism. A 32-ye
ar-old woman with primary hypothyroidism presented with amenorrhoea an
d galactorrhoea of two years' duration, She had hyperprolactinaemia, l
ow basal morning cortisol levels and evidence of a pituitary macroaden
oma on magnetic resonance imaging, Therapy with L-thyroxine resulted i
n induction of regular menses, resolution of galactorrhoea, normalisat
ion of hormone levels and disappearance of the image of pituitary macr
oadenoma, It seems that enlargement of the pituitary due to thyrotroph
and/or lactotroph cell hyperplasia secondary to hypothyroidism is res
ponsible for this 'pseudotumour' image on radiological study, Recovery
of her low basal cortisol values during treatment could also be expla
ined by the dissolution of the pressure effect of enlarged pituitary i
n addition to the regression of hypothyroidism, In subjects with prima
ry hypothyroidism and hyperprolactinaemia and pituitary enlargement, t
hyroid hormone replacement should be a first line treatment preceding
pituitary surgery and bromocriptine use.