J Endocrinol Metab

Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc

Journal website https://jem.elmerpub.com

Case Report

Volume 15, Number 1, March 2025, pages 34-38

Pituitary Macroadenoma With Partial Transient Hypopituitarism

Figure 1. MRI of the brain showing tumor process in the sella turcica with signs of pituitary macroadenoma (sagittal plane). The arrow indicates the tumor mass. MRI: magnetic resonance imaging.

Figure 2. Follow-up postoperative MRI of the brain. No evidence of recurrence or residual tumor mass in the pituitary gland was found. “Empty sella” was found, without any current data on pathological changes in the brain (sagittal plane). The arrow indicates the pituitary region. MRI: magnetic resonance imaging.

**Table 1.** Basic Investigations
Lab test	Value	Reference range
ACTH: adrenocorticotropic hormone; anti-Tg-Ab: anti-thyroglobulin antibody; anti-TPO-Ab: anti-thyroid peroxidase antibody; FSH: follicle-stimulating hormone; FT4: free thyroxine; FT3: free triiodothyronine; GH: growth hormone; LH: luteinizing hormone; TSH: thyroid-stimulating hormone.
Hemoglobin, g/L	147	140 - 180
Fasting glucose, mmol/L	4.61	2.8 - 6.1
Serum potassium, mmol/L	4.6	3.5 - 5.6
Serum sodium, mmol/L	147	136 - 151
Serum chlorine, mmol/L	105	96 - 110
Urea, mmol/L	4.2	2.6 - 7.2
Creatinine, µmol/L	101	44 - 96
TSH, mU/L	0.243↓	0.34 - 5.6
FT4, pmol/L	4.58↓	7.86 - 14.41
FT3, pmol/L	3.79↓	3.8 - 6.0
Prolactin, mU/L	1,675.7↑	70 - 565
LH, IU/L	0.28↓	1.24 - 8.62
FSH, mIU/mL	1.48	1.27 - 19.26
Testosterone, ng/mL	0.0↓	1.75 - 7.81
Cortisol - 8 h, nmol/L	194.35	154 - 624
Cortisol - 23 h, nmol/L	100.11
ACTH, pg/mL	28.08	5 - 47
GH, ng/mL	0.291	0.05 - 3
Anti-Tg-Ab, IU/mL	< 0.9	0 - 4
Anti-TPO-Ab, IU/mL	< 0.25	0 - 9

Table 1. Basic Investigations

Lab test

Value

Reference range

ACTH: adrenocorticotropic hormone; anti-Tg-Ab: anti-thyroglobulin antibody; anti-TPO-Ab: anti-thyroid peroxidase antibody; FSH: follicle-stimulating hormone; FT4: free thyroxine; FT3: free triiodothyronine; GH: growth hormone; LH: luteinizing hormone; TSH: thyroid-stimulating hormone.

Hemoglobin, g/L

147

140 - 180

Fasting glucose, mmol/L

4.61

2.8 - 6.1

Serum potassium, mmol/L

4.6

3.5 - 5.6

Serum sodium, mmol/L

147

136 - 151

Serum chlorine, mmol/L

105

96 - 110

Urea, mmol/L

4.2

2.6 - 7.2

Creatinine, µmol/L

101

44 - 96

TSH, mU/L

0.243↓

0.34 - 5.6

FT4, pmol/L

4.58↓

7.86 - 14.41

FT3, pmol/L

3.79↓

3.8 - 6.0

Prolactin, mU/L

1,675.7↑

70 - 565

LH, IU/L

0.28↓

1.24 - 8.62

FSH, mIU/mL

1.48

1.27 - 19.26

Testosterone, ng/mL

0.0↓

1.75 - 7.81

Cortisol - 8 h, nmol/L

194.35

154 - 624

Cortisol - 23 h, nmol/L

100.11

ACTH, pg/mL

28.08

5 - 47

GH, ng/mL

0.291

0.05 - 3

Anti-Tg-Ab, IU/mL

< 0.9

0 - 4

Anti-TPO-Ab, IU/mL

< 0.25

0 - 9

**Table 2.** Hormonal Results During the First Hospitalization and the Follow-Up Period
Test	First month after TSA	2 months	6 months	8 months	10 months	12 months	Reference range
ACTH: adrenocorticotropic hormone; FSH: follicle-stimulating hormone; FT3: free triiodothyronine; FT4: free thyroxine; LH: luteinizing hormone; TSA: thyroid-stimulating antibody; TSH: thyroid-stimulating hormone.
LH	0.28	1.43	2.01	1.94	1.87	1.72	1.24 - 8.62 IU/L
FSH	1.48	1.56	2.72	2.59	2.86	2.37	1.27 - 19.26 mIU/mL
Testosterone	0.0	1.15	1.77	1.74	1.72	1.98	1.75 - 7.81 ng/mL
ACTH	28.08	25.23	26.9	24.4	22.6	19.65	5 - 47 pg/mL
Cortisol - 8 h	194.35	216.61	250.74	269.5	211.33	227.74	154 - 624 nmol/L
TSH	0.243	0.972	0.696	0.749	0.866	0.817	0.34 - 5.6 mIU/L
FT4	4.58	22.33	13.87	12.24	11.17	11.8	7.86 - 14.41 pmol/L
FT3	3.79	4.26	4.34	5.04	4.72	4.59	3.8 - 6.0 pmo/L

Table 2. Hormonal Results During the First Hospitalization and the Follow-Up Period

Test

First month after TSA

2 months

6 months

8 months

10 months

12 months

Reference range

ACTH: adrenocorticotropic hormone; FSH: follicle-stimulating hormone; FT3: free triiodothyronine; FT4: free thyroxine; LH: luteinizing hormone; TSA: thyroid-stimulating antibody; TSH: thyroid-stimulating hormone.

0.28

1.43

2.01

1.94

1.87

1.72

1.24 - 8.62 IU/L

FSH

1.48

1.56

2.72

2.59

2.86

2.37

1.27 - 19.26 mIU/mL

Testosterone

0.0

1.15

1.77

1.74

1.72

1.98

1.75 - 7.81 ng/mL

ACTH

28.08

25.23

26.9

24.4

22.6

19.65

5 - 47 pg/mL

Cortisol - 8 h

194.35

216.61

250.74

269.5

211.33

227.74

154 - 624 nmol/L

TSH

0.243

0.972

0.696

0.749

0.866

0.817

0.34 - 5.6 mIU/L

FT4

4.58

22.33

13.87

12.24

11.17

11.8

7.86 - 14.41 pmol/L

FT3

3.79

4.26

4.34

5.04

4.72

4.59

3.8 - 6.0 pmo/L