Skip to main content
. 2020 Jun 24;13:1179551420932921. doi: 10.1177/1179551420932921

Table 1.

Evaluation of pituitary function in intrasellar masses.

Measurements:
Serum IGF1, cortisol (09:00 am), prolactin, FSH/LH, oestradiol (females)/testosterone (males), TSH, and FT4
Check for hormone hypersecretion:
• If IGF1 is elevated, further evaluation for GH excess
• Screening for glucocorticoid excess (overnight dexamethasone suppression test, 24-hour urinary free cortisol, midnight salivary cortisol) may be considered, regardless of clinical suspicion
Check for hypopituitarism:
• In case of suspected GH deficiency, GH stimulation testing is recommended. Biochemical testing for GHD can be avoided in patients with clear-cut features of GHD and 3 other documented pituitary hormone deficits. Insulin tolerance test/GHRH + arginine/glucagon tests may be performed.
• Adrenal insufficiency (AI) is indicated by a basal cortisol level < 3 μg/dL and a cortisol level > 15 μg/dL likely excludes an (AI) diagnosis. One of the following dynamic tests (ACTH stimulation test/ITT/low dose ACTH stimulation test) may be performed to check for central adrenal insufficiency. Peak cortisol levels less than 18.1 μg/dL (500 nmol/L) at 30 or 60 minutes indicates adrenal insufficiency.
Additional appropriate screening and follow-up investigations are needed in patients with personal or family history of multiple endocrine neoplasia.

Source: Freda et al2 and Lloyd et al.50

Abbreviations: ACTH, adrenocorticotropic hormone; FSH, follicle-stimulating hormone; GH, growth hormone; GHD, growth hormone deficiency; LH, luteinizing hormone; TSH, thyroid-stimulating hormone.