Case Report

Simultaneous Coexistence of Thyrotropin-Prolactin-Secreting Adenoma and Papillary Thyroid Carcinoma

Table 3

The differential diagnosis markers between TSH-secreting adenomas (TSHomas) and resistance to thyroid hormones (RTH).

TSHomaRTH

Family history of thyroid diseaseAbsent85%
Unsuppressed TSH or increasedPresentPresent
Elevated thyroid hormone levelsPresentPresent
Nycthemeral profile of TSHAbsentPresent
High levels of SHBG (TeBG)PresentAbsent
Increased α subunit65%3%
α-GSU/TSH molar ratio>1%<1%
Increase in TSH after a TRHNegativePositive
T3 suppression testNo TSH suppressionSuppression of TSH
Somatostatin testFT4 ↓ >30%FT4 is not affected
Multihormonal productionPossibleAbsent
MRI pituitary98%10–20%
DNA mutation analysis+