PMC9816123_01
(A) Inhibition assay before treatment with glucose. (B) Inhibition assay before treatment with somatostatin. (C) Postoperative reports of the glucose suppression test. GH, growth hormone; TSH, thyroid-stimulating hormone; FT3, free triiodothyronine; FT4, free thyroxine.
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TPOAb, and TgAb all showed negative findings. The rest of the laboratory tests are shown in  Table 1  and  Figure 1 . ACTH (-), Ki-67 (even +, <1%), PIT-1 (+), SF-1 (+), and T-PIT (-). Pathological diagnosis of pituitary adenoma was made with immunohistochemistry reports of positive GH, luteinizing hormone (LH), and scattered positive prolactin (PRL). The results of the glucose suppression test on the 7th day postsurgery are shown in  Figure 1C . After the surgery, the patient was treated with levothyroxine, steroid, and antihypertensive medications.
(A) Pituitary MRI before treatment: a large mass of equal T1, slightly longer T2 signal foci in the saddle area, clear boundaries, about 2.6 x 2.7 x 4.7 cm in size, protruding upward into the suprasellar cistern, semi-enveloping the internal carotid arteries on both sides, and the optic chiasm pressured upward. (B) Pituitary MRI after 6 months of octreotide: similar to that before treatment. (C) Pituitary MRI 9 months after surgery.
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Imaging diagnosis showed a space-occupying lesion in the sellar region, most likely to be a pituitary tumor ( Figure 2 ).