A 56-year-old man was referred urgently by an ophthalmologist after presenting with a 6-month history of deteriorating vision. The patient had a 40 pack-year smoking history. Before his vision problem, he had never visited his general practitioner.
Investigations:
serum cortisol (09.00 h)389 nmol/L (200C700)
serum testosterone8.6 nmol/L (9.0C35.0)
plasma follicle-stimulating hormone2.1 U/L (1.0C7.0)
plasma luteinising hormone2.4 U/L (1.0C10.0)
serum prolactin896 mU/L (<360)
serum thyroid-stimulating hormone1.4 mU/L (0.4C5.0)
MR scan of pituitarysee image
What is the most likely diagnosis?
A . craniopharyngioma
B . meningioma
C . non-functioning adenoma
D . prolactinoma
E . Rathke’s cyst
Answer: B
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