CASE REPORT article
Front. Med.
Sec. Pathology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1601190
Pituitary hyperplasia secondary to long-neglected severe primary hypothyroidism：a case of misdiagnosis and lessons learned
Provisionally accepted
- 1Cixi People's Hospital, Ningbo, China
- 2Ningbo Medical Centre Lihuili Hospital, Ningbo, Zhejiang Province, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Primary hypothyroidism is defined by a loss of thyroxine feedback inhibition and an excess of thyrotropin-releasing hormone (TRH), can lead to reactive pituitary hyperplasia. However, pituitary hyperplasia secondary to primary hypothyroidism primary hypothyroidism leads to pituitary hyperplasia (PHPH) is uncommon, especially with pituitary mass compression symptoms. Case summary: A patient with menstrual irregularities and hyperprolactinemia exhibited pituitary enlargement on magnetic resonance imaging (MRI). Initial treatment with Bromocriptine Mesylate failed, leading to surgical resection. Preoperative evaluation revealed severe hypothyroidism. Postoperatively, medication discontinuation resulted in elevated thyroid-stimulating hormone (TSH). Reticulin staining confirmed TSH hyperplasia, likely due to long-standing, untreated hypothyroidism since childhood. Postoperative thyroid hormone therapy normalized thyroid and pituitary function. Conclusion: This case underscores the importance of recognizing long-standing hypothyroidism as a potential cause of pituitary hyperplasia. Accurate diagnosis is essential to avoid unnecessary surgical or pharmacological interventions.
Keywords: Primary hypothyroidism, Pituitary hyperplasia, Hyperprolactinemia, Pituitary macroadenoma, Pathology
Received: 27 Mar 2025; Accepted: 01 Aug 2025.
Copyright: © 2025 Du, Sun B#, Zhao, Wang, Li and Chen. 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) or licensor 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.
* Correspondence:
Wei Li, Ningbo Medical Centre Lihuili Hospital, Ningbo, 315010, Zhejiang Province, China
Jianwei Chen, Cixi People's Hospital, Ningbo, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.