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Non-functioning pituitary adenoma — SCE Endocrinology MCQ

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ModeratePituitaryNon-functioning pituitary adenomaSCE Endocrinology

A 58-year-old man has recurrent headaches and a pituitary macroadenoma. IGF-1 is normal, prolactin is mildly raised and overnight dexamethasone suppresses cortisol to 30 nmol/L. What is the most likely tumour type?

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Correct answer: D — Non-functioning pituitary adenoma

Normal IGF-1, normal cortisol suppression and mild prolactin elevation from stalk effect support a non-functioning macroadenoma. Macroprolactinoma typically causes much higher prolactin, subject to hook effect checks. Functional adenomas should be excluded biochemically before labelling a lesion non-functioning.

Reference: Society for Endocrinology Pituitary Guidance