A 45-year-old man presents with progressive frontal headaches, bitemporal hemianopsia, and erectile dysfunction for 3 months. Vital signs: BP 138/88 mmHg, HR 76/min, RR 14/min, Temp 37°C, SpO2 98% on room air. Laboratory studies show elevated prolactin (125 ng/mL), normal TSH (2.1 mIU/L), and low testosterone (185 ng/dL). MRI reveals a 1.8-cm sellar mass with suprasellar extension compressing the optic chiasm. Visual acuity is preserved. Which diagnosis is most likely?
- A)ProlactinomaGABARITO
- B)ACTH-secreting adenoma
- C)Growth hormone-secreting adenoma
- D)Non-functioning pituitary adenoma
- E)TSH-secreting adenoma
Explicação
Prolactinomas are the most common functional pituitary adenomas. The markedly elevated prolactin (>200 ng/mL suggests macroadenoma), combined with mass effect symptoms (headache, bitemporal hemianopsia) and hypogonadism, confirms the diagnosis. The sellar mass... Ver explicação completa e trilha adaptativa →