4th April 2024

A 57-year-old woman came in with a history of long-standing headache

A 57-year-old woman came in with a history of long-standing headache, which has been more severe early in the morning. She was previously treated for migraine and tension headache but all treatments were futile. She now complains of polydipsia and nocturia but no weight loss or respiratory symptoms. She had an MRI head, which showed a brain tumour above the pituitary gland. Her blood test revealed TSH 4.2 mIU/L, IGF-1 9.5 nmol/L (normal range 8.5- 25.4 nmol/L), prolactin 18 microgram/L (normal range < 25 microgram/L), gonadotrophin level 2.5 mIU/ml (Normal range <5 mIU/ml), HbA1c 35 mmol/mol, random glucose 8.3 mmol/L, urine osmolality 286mOsmol/kg, morning cortisol levels 520 nmol/L. What is the most likely cause of her symptoms?

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