Next Questions:

Does he need neurosurgery? What do you want to find out about the mass?

Which rule of endocrine is now violated?

What is relevant in his ROS to this pituitary mass and what extra labs do you want to order? (Think about your response and THEN scroll down to see if you had the complete workup)

Special Labs:

Na improved to 131-134 with hydration, K normal.

TSH 1.67 (normal range), Free T4 0.47 (normal 0.8-1.8)

AM cortisol 1 (5-18 normal) ACTH 6 (normal 6-50)

Testosterone am: < 10, LH/FSH: 0.4/1.11 (within range)

Prolactin > 2000 (normal < 20)

CT chest: Normal except some mediastinal and hilar adenopathy

CT abdomen: R renal mass, found to be cyst by US (known to patient)

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