Conclusion and Results (Outcome and follow-up):
After four weeks, the patient achieved a euthyroid state and subsequently underwent endoscopic trans-sphenoidal surgery. Postoperatively, serum TSH, FT4, and FT3 levels decreased to within the normal range.
This case illustrates that the elevated TSH was due to the rare condition of TSHoma, which required timely surgical intervention. However, due to a misdiagnosis and prior treatment with thyroxine replacement, the patient’s symptoms were initially aggravated, delaying appropriate management.