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July 24, 1981

Primary HypothyroidismSuprasellar Pituitary Enlargement and Regression on Computed Tomographic Scanning

JAMA. 1981;246(4):364-365. doi:10.1001/jama.1981.03320040036027

THE ASSOCIATION between primary hypothyroidism in adults and pituitary enlargement was first described in 1892.1 Similar cases have been reported recently.2-5 They have been characterized by enlargement or alteration in contour of the sella turcica. A decrease in pituitary size following thyroxine (T4) replacement therapy has been reported by Jawadi et al,6 who demonstrated regression of suprasellar expansion with pneumoencephalography, and by Pita et al,7 who reported disappearance of a pituitary tumor on computed tomographic (CT) scan.

A case of suprasellar extension of pituitary tissue in a patient with severe hypothyroidism has been easily demonstrated by CT scanning using both transverse and coronal sections. The unusual feature of the case is that no abnormalities were noted on sella tomography. With supervised T4 replacement, the CT changes completely resolved within two months.

Report of a Case  A 23-year-old woman was admitted for right optic neuritis.