Endocrinology

Answer 1 Perform a visual fields test. According to results of her hormonal work-up (ie, normal pituitary hormone levels), this patient has a nonfunctioning pituitary incidentaloma. To select a treatment strategy, a visual fields test is needed to determine if the pituitary mass is putting pressure on the optic chiasm. Bromocryptine would not be beneficial in this setting, and surgical intervention becomes an important consideration when there is a visual field abnormality.1 Neither DEXA bone scan nor estrogen replacement therapy is necessary at this point. REFERENCE 1. Mavrakis AN, Tritos NA. Diagnostic and therapeutic approach to pituitary incidentalomas. Endocrine Pract 2004;10:438-44. Click here to return to the questions

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