MRI of the pituitary.        

The rationale for this imaging procedure is to exclude a TSH-producing adenoma. However this patient has goiter since early childhood and hypothyroidism. Patients with this rare disorder of TSH producing adenoma are usually mildly hyperthyroid and have symptoms of a large pituitary adenoma (visual fields). Therefore the pituitary MRI is not mandatory in this patient. (Ref: Beck-Peccoz et al: TSH secreting pituitary tumours  Endocrine Rev 1996; 17:610). GO BACK