Abstract
Investigations: Endocrine profiling confirmed acromegaly on OGTToral glucose tolerance test (non-suppressed nadir GH level of 1.2 ug/L with basal GH level of 1.5 ug/L). IGF 1 level was elevated at 64 (9.5-45) nmol/L. There was significantly elevated FSH level of 107.2 (1-10.1) U/l with LH 1.2 (1.5-6.3) U/l and testosterone 9.3 (8-29) nmol/l. The rest of pituitary profiling was normal: Prolactin 370 (45375) mU/L, TSH 0.65 (0.35 to 5.5) mU/L, FT4 12.3 (10-19.8) pmol/L, normal short syn cthen test. US testes confirmed bilateral testicular enlargement: left testis measuring 46cc and right testis measuring 50c with no neoplastic changes. MRI pituitary demonstrated a large pituitary macroadenoma 3.5x 2.8 cm, with the expansion of pituitary fossa, compressing optic chaism and extending into left cavernous sinus.
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