papillary carcinoma and lymph node metastases. She was reoperated in 1972
I scanning, but no
because two radioactive sites were seen in the neck on
recurrent disease was found at surgery. During examination at Tripler Army

Medical Center in April 1976, a routine skull x-ray showed erosion of the

anterior floor of the sella turcica and a mass extending into the sphenoid

sinus.
There were no related symptoms and no visual field loss, and menses
Thyroid hormone treatment had been discontinued for radioiodine
were normal.

testing, and the serum thyroid stimulating hormone (TSH) was elevated (Table
3A). Serum follicle-stimulating hormone (FSH) and luteinizing hormone (LH)

were high and growth hormone (GH) was normal.

Table 3.

Endocrine function tests on pituitary tumor case:

(normal values in parentheses).

A.
April 1976
Serum TSH

FSH
LH

GH

Ty,
T3
B.

May

Serum

1976

116

59

4

w/ml

(<5)

miU/mi

(<20)

mIU/ml (20-30)
ng/ml

(0.2-5)

0.3 ug/dl (5-10)
16

ng/di

(60~160)

FSH

31.2

mIU/ml (follicular 9-27, mideycle 7-41)

LH

18.2
17.6
9.1
8.0

mIU/ml (follicular 6-27, midcycle 45-154)
mIU/ml (luteal 5-17, postmenopausal 39-96)
ng/ml (16.2 + <2)
ng/ml

PRL
estradiol

AM cortisol

27.8

44

58
10

ll

mIU/ml (luteal 5-15, postmenopausal 35-217)

pg/ml

(follicular 10-100, midcycle 170-770)

pg/ml
ug/dl

(luteal 190-340, postmenopausal <10-140)
(6-26)

g/dl

Ty,

9.4 yg/dl (4.6-10.7)

T3

149

FT,

Urine

9.8

hormone levels

17-OH corticoids
l7+ketosteroids

2.7

ng/dl

ng/dl

(1.0-2.3)
(110-230)

1.6, 2.2, 1.2, 1.5 mg/24 hr (2.0-6.0)
4.0, 5.0, 2.0, 4.0 mg/24 hr (9.0-22.0)

She was admitted to the Clinical Center of the National Institutes of
Health on 18 May 1976 for further study.
Laboratory tests showed normal
electrolytes, and the results of endocrine function tests (Table 3B) were
within normal limits except for a slight decrease in the 24-hr urinary 17hydroxycorticoids and 1?-ketosteroids.
Skull x rays and sella tomograms

revealed an asymmetric erosion in the anterior floor of the sella with extension of a soft tissue mass into the sphenoid sinus.
Computerized tomography
showed no supracellular extension.
Visual fields were normal.

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