PITUITARY-TUMOR INVESTIGATIONS

SUMMARY

1. Prolactin

2. IGF-1 to screen for acromegaly

3. 24-hour urine free cortisol concentration or 1 mg overnight dexamethasone suppression test (if suspected cortisol excess) or ACTH stimulation (if suspected cortisol deficiency)

4. TSH & free thyroxine (FT4)

5. Alpha subunit, FSH & LH

NB: alpha subunits are inactive pieces of glycoprotein, when increased, support a diagnosis of gonadotroph adenoma. Finding these subunits indicates that a pituitary mass is definitely pituitary in origin (vs. non-pituitary, such as craniopharyngioma).

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].