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16th September 2024
A 41-year-old female presents to the endocrine clinic after completing treatment for squamous cell carcinoma
A 41-year-old female presents to the endocrine clinic after completing treatment for squamous cell carcinoma of the head and neck managed with local radiation and resection four years ago. She experiences weight gain and lethargy. Bloods were taken, which showed the following:
| ACTH | 30 ng/l (0-40) |
| Cortisol 9 am | 450 nmol/l (171-536) |
| Total testosterone | 2 ng/ml (1.42-9.32) |
| Free testosterone | 20 pg/ml (5.0-28.8) |
| TSH | 4 mU /l (0.38 -5.33) |
| Free T4 | 13 pmol/l (7.9-14.4) |
| Prolactin | 890 mIU /l (< 700) |
| IGF-1 | 90 ng/ml (115-307) |
| GH | 0.25 ng/ml (0.003-0.971) |
| LH (luteal phase) | 6.7 IU/l (0.5-14) |
| FSH (luteal phase) | 7.2 IU/l (1.0-11) |
What of the following is the most likely diagnosis?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
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