Conclusion and Results (Outcome and follow-up):
Her symptoms improved significantly as her TSH levels normalized. A
follow-up MRI after two years showed a reduction in the size of the
pituitary adenoma, although complete resolution was not achieved. The
MRI report indicated a decrease in the non-enhancing lesion on the right
side of the pituitary gland, now measuring 6.8 x 6.7 x 5 mm, compared to
the previous measurement of 7.3 x 6.8 x 6.4 mm. Additionally, the
pituitary gland showed a slight size reduction, now measuring 19 x 6 mm,
down from 20 x 8 mm on the previous scan (Figure 9 and 10).
This case suggests that the pituitary adenoma developed secondary to
primary hypothyroidism. While the hyperplasia resolved with medical
treatment, the adenoma remained present despite normalization of thyroid
hormone levels. It was suspected that the patient had both pituitary
adenoma and hyperplasia; the hyperplasia responded to treatment, but the
adenoma persisted.