MRCP2-1521

MRCP2-1521

A 35-year-old woman presents to the endocrinology clinic with a 3-week history of intermittent headaches and milky discharge from her nipples. She also reports missing her menstrual periods for the past 6 months despite having a regular 28-day cycle. The patient has no significant medical history and no known allergies.

Lab results:

– Thyroid-stimulating hormone (TSH): 0.6 mU/L (0.5-5.5)
– Free thyroxine (T4): 8.2 pmol/L (9.0-18.0)
– Adrenocorticotrophic hormone: 8 ng/L (0-47)
– Insulin-like growth factor 1 (IGF-1): 11 nmol/L (12.4-30.3)
– Prolactin: 5500 IU/mL (59-619)
– β-HCG: <1 u/L (<1) An MRI of the head reveals a pituitary adenoma measuring approximately 1.5cm, which is compressing the optic chiasm. What is the most appropriate next step in managing this patient’s likely diagnosis?