skip to main content

Pituitary incidentaloma — SCE Endocrinology MCQ

Instant feedback + full explanation. One question, done properly.

HardPituitaryPituitary incidentalomaSCE Endocrinology

A 64-year-old man has a 1.2 cm pituitary incidentaloma. He has no visual symptoms. Prolactin, IGF-1 and 09:00 cortisol are normal; free T4 is normal. MRI shows no optic chiasm contact. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: DEndocrine review with interval MRI and visual assessment if growth approaches the chiasm

Endocrine review with interval MRI and visual assessment if growth approaches the chiasm is best because a non-functioning incidentaloma without chiasmal contact or hormone excess is usually monitored with endocrine follow-up and interval imaging. The alternatives are less appropriate because surgery is reserved for growth or compression; discharge misses progression; cabergoline is not indicated; radiotherapy is disproportionate. The SCE teaching point is to integrate the clinical pattern, biochemistry and context rather than treating an isolated result.

Reference: Endocrine Society pituitary incidentaloma guideline