AB020. SOH24AB_124. Paediatric pituitary macroadenoma secondary to primary hypothyroidism
Paediatric Session

AB020. SOH24AB_124. Paediatric pituitary macroadenoma secondary to primary hypothyroidism

Padraic Ryan, Moira Marks, Lizeri Jansen, Siobhan McGrane, Clodagh O’Gorman

Department of Paediatrics, University Hospital Limerick, Dooradoyle, Limerick, Ireland

Background: Paediatric pituitary adenomas are rare intracranial neoplasms that can manifest clinically as neurological symptoms or endocrine disorder due to mass effect and/or disruption of hormone secretion. Current treatment options for pituitary adenomas include medical management with pharmacologic agents, surgical resection and radiation therapy. In this report we examine a case of pituitary macroadenoma secondary to primary hypothyroidism.

Methods: A previously well 11-year-old boy was referred to Department of Paediatrics due to faltering growth and a six-month history of decreased energy and appetite, abdominal distention and early morning vomiting. His weight was on the 75th centile and height was on the 9th centile. His abdomen was distended but physical examination was otherwise unremarkable.

Results: Initial blood tests showed elevated thyroid stimulating hormone (TSH), prolactin and thyroid antibodies and decreased free thyroxine (T4). X-ray imaging determined bone age to be delayed compared to chronological age. Brain magnetic resonance imaging (MRI) revealed a pituitary macroadenoma exerting mass effect on the pituitary stalk and optic chiasm. The patient was commenced on low dose Levothyroxine, which was gradually increased in response to interval monitoring of thyroid function tests (TFTs). This corresponded with an improvement in symptoms. Subsequent MRI showed a significant reduction in pituitary adenoma size with no residual mass effect, representing a response to treatment.

Conclusions: Pituitary adenomas can be extremely difficult to manage. There is added complexity when this pathology occurs in the paediatric population as it can have serious consequences on growth and development. Treatment with levothyroxine can result in improved outcomes for paediatric patients with a pituitary macroadenoma secondary to primary hypothyroidism.

Keywords: Paediatric; pituitary; macroadenoma; levothyroxine; hypothyroidism

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-24-ab020
Cite this abstract as: Ryan P, Marks M, Jansen L, McGrane S, O’Gorman C. AB020. SOH24AB_124. Paediatric pituitary macroadenoma secondary to primary hypothyroidism. Mesentery Peritoneum 2024;8:AB020.

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