Table 1. Preoperative endocrinological and radiological evaluation.
| Study | Results | |
|---|---|---|
| Basal hormone test | Serum cortisol | 70.1 mcg/dL (reference: 6–23 mcg/dL) |
| Plasma ACTH | 291.4 pg/mL (reference: 7.2–63.3 pg/mL) | |
| 24 hr-urine cortisol | 7665 mcg/day (reference: 58.00–403.00 mcg/day) | |
| Low-dose DMST | Not suppressed | |
| Serum cortisol 39.9 mcg/dL, Plasma ACTH 218.90 pg/mL | ||
| High-dose DMST | Not suppressed | |
| Serum cortisol 34.8 mcg/dL, Plasma ACTH 159.10 pg/mL | ||
| IPSS | Left inferior petrosal sinus dominant | |
| Basal inferior petrosal sinus/peripheral 2.4 (Reference: >2.0) | ||
| Sellar dynamic MRI | No evidence of pituitary adenoma | |
| Tumor in the sinonasal cavity with intracranial and intraorbital extension | ||
| 68Gallium-DOTA-TOC PET | Suggesting neuroendocrine tumor in nasal cavity | |
| Normal hot uptake of pituitary grand | ||
| Whole body bone scan | No distant metastasis | |
ACTH, adrenocorticotropic hormone; DMST, dexamethasone suppression test; IPSS, inferior petrosal sinus sampling; MRI, magnetic resonance imaging; PET, positron emission tomography.