A 34-year-old man was admitted to the hospital with diabetic ketoacidosis. He reported having had blurry vision, increasing shoe size, and a change in his facial features over the past several years. On exam, he was found to have bitemporal hemianopsia. Which of the following is the most likely cause of his presentation?患者男，34岁，因糖尿病酮症酸中毒入院。他报告在过去几年中视力模糊、鞋尺寸增大和面部特征改变。检查时，发现他患有双颞侧偏盲。以下哪一项是他就诊的最可能原因？
A. Anabolic steroid use
B. Beckwith–Wiedemann syndrome
C. Nelson’s syndrome
D. Pachydermoperiostosis
E. Somatotropic pituitary adenoma
答案解析：
正确的答案是促生长激素性垂体腺瘤。实验室检查显示胰岛素样生长因子1和生长激素水平升高，确诊为肢端肥大症。头部磁共振成像显示垂体大腺瘤，然后切除，病理发现生长激素染色阳性。给予奥曲肽治疗，初次手术后8个月需二次切除。
正确答案：E
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