RESUMO
Two patients with sublingual thyroid glands and hypothyroidism since childhood are described. Because of enlargement of the sella turcica both were erroneously diagnosed as having primary pituitary tumors resulting in secondary hypothyroidism. One of the patients was even treated with pituitary gland irradiation. Following substitution thyroid therapy, thyroid-stimulating hormone (TSH) levels promptly returned to normal. Ectopic thyroid glands, which are often incapable of adequate hormonogenesis, may cause secondary pituitary enlargement and lead to the suspicion of a pituitary adenoma. The correct diagnosis can easily be established by measuring serum TSH levels, which are elevated in the former condition.
Assuntos
Hipotireoidismo/complicações , Doenças da Hipófise/diagnóstico , Hipófise/patologia , Glândula Tireoide/anormalidades , Adulto , Diagnóstico Diferencial , Hormônio Foliculoestimulante/sangue , Humanos , Hiperplasia , Hormônio Luteinizante/sangue , Masculino , Hormônios Tireóideos/sangueRESUMO
A 26-year-old man with the Nelson's syndrome is described, in whom an abdominal tumour developed, accompanied by recurrent Cushing's syndrome 11 years after total adrenalectomy. Upon removal the tumour was a myelolipoma containing islands of adrenocortical-like elements. On incubation of the tumour with radioactive precursors, its capacity to produce cortisol in vitro was shown. The name adrenocortico-myelolipoma is suggested for this tumour.
Assuntos
Neoplasias Abdominais/etiologia , Córtex Suprarrenal , Coristoma , Hormônios Ectópicos , Síndrome de Nelson/complicações , Síndromes Endócrinas Paraneoplásicas , Neoplasias Hipofisárias/complicações , Mielofibrose Primária/etiologia , Neoplasias Abdominais/metabolismo , Neoplasias Abdominais/patologia , Córtex Suprarrenal/metabolismo , Córtex Suprarrenal/patologia , Adrenalectomia , Adulto , Síndrome de Cushing/etiologia , Humanos , Hidrocortisona/biossíntese , Técnicas In Vitro , Masculino , Mielofibrose Primária/metabolismo , Mielofibrose Primária/patologiaAssuntos
Ecocardiografia , Hipertireoidismo/fisiopatologia , Contração Miocárdica/efeitos dos fármacos , Adulto , Antitireóideos/farmacologia , Antitireóideos/uso terapêutico , Depressão Química , Feminino , Frequência Cardíaca/efeitos dos fármacos , Ventrículos do Coração/efeitos dos fármacos , Hemodinâmica/efeitos dos fármacos , Humanos , Hipertireoidismo/diagnóstico , Hipertireoidismo/tratamento farmacológico , Pessoa de Meia-Idade , Propranolol/farmacologia , Propranolol/uso terapêuticoRESUMO
Thyrotropin (TSH)-stimulation tests were performed on 21 patients with solitary hot nodules in the thyroid gland. Twelve of the patients were euthyroid and nine were hyperthyroid. The average age of the euthyroid patients was 38 +/- 14 (SD) years, and that of the hyperthyroid patients, 55 +/- 8 years. Prior to TSH stimulation, the scanograms of the euthyroid patients showed 131I uptake only in the nodules, while after the TSH test, almost equal uptake was observed in both lobes. The scanograms of the hyperthyroid patients that showed 131I uptake only in the area of the nodules prior to the TSH test showed no appreciable change after TSH stimulation.
Assuntos
Hipertireoidismo/diagnóstico , Tireotropina , Adulto , Fatores Etários , Idoso , Feminino , Humanos , Radioisótopos do Iodo , Masculino , Pessoa de Meia-Idade , Cintilografia , Estimulação Química , Testes de Função TireóideaRESUMO
A metabolic study with tissue from a virilizing arrhenoblastoma, using as precursors [7-3H]pregnenolone, [7-3H]17alpha-hydroxypregnenolone,[4-14C]17alpha-hydroxyprogesterone and [4-14C]testosterone, revealed that in spite of a deficient activity of 3beta-hydroxysteroid dehydrogenase-5-isomerase the overall production of testosterone was compensated by an increased activity of a lyase converting [4-14C]17alpha-hydroxyprogesterone to testosterone (via androstenedione) and was comparable to the production obtained by normal ovarian tissue. The masculinizing effects of the tumour in vivo were most probably caused by accumulation of testosterone due to deficiencies in enzymes catabolizing testosterone to 17-ketosteroids and its aromatization to oestrogen. The unique property of the arrhenoblastoma to convert [4-14C]17alpha-hydroxyprogesterone to [4-14C]11-deoxycortisol (Reichstein's compound S) suggests an adrenal origin of the tumour which may explain its limited capacity to aromatize testosterone.
