{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T06:34:48Z","timestamp":1769150088725,"version":"3.49.0"},"reference-count":6,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,11,10]]},"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:p>Plurihormonal pituitary adenomas are rare forms of pituitary adenomas that express more than one hormone. The most common association is with growth hormone (GH) and prolactin. Cosecretion of GH and adrenocorticotrophic hormone (ACTH) is rare with only 25 reported cases in literature. Most presented with features of GH excess, and only four presented with Cushing\u2019s disease. We report a case of a woman in her 30s with recurrent plurihormonal pituitary macroadenoma cosecreting GH and ACTH, diagnosed during workup for polycystic ovarian syndrome, and both times presenting uniquely with Cushing\u2019s disease. Biochemical testing showed GH excess and hypercortisolism. She underwent transsphenoidal surgery twice and immunohistochemistry showed positive staining for GH and ACTH on both occasions. We aim to raise more awareness of this rare type of pituitary adenoma, shed light on the importance of recognising rare presentations and highlight the necessity of rigorous follow-up given morbidity and potentially higher mortality risk.<\/jats:p>","DOI":"10.1136\/bcr-2022-251451","type":"journal-article","created":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T11:10:17Z","timestamp":1669029017000},"page":"e251451","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Plurihormonal pituitary adenoma cosecreting ACTH and GH: a rare cause of Cushing\u2019s disease"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6421-488X","authenticated-orcid":false,"given":"Jumana","family":"Amir","sequence":"first","affiliation":[{"name":"Endocrinology, McGill University Health Centre, Montreal, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie Christine","family":"Guiot","sequence":"additional","affiliation":[{"name":"Neuropathology, McGill University Health Centre, Montreal, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasha","family":"Garfield","sequence":"additional","affiliation":[{"name":"Endocrinology, McGill University Health Centre, Montreal, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,11,21]]},"reference":[{"key":"2025082709273079000_15.11.e251451.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2018.02.120"},{"key":"2025082709273079000_15.11.e251451.2","doi-asserted-by":"crossref","DOI":"10.1186\/s13256-021-02948-6","article-title":"Plurihormonal pituitary macroadenoma: a case report","volume":"15","author":"Allehaibi","year":"2021","journal-title":"J Med Case Rep"},{"key":"2025082709273079000_15.11.e251451.3","doi-asserted-by":"crossref","first-page":"A602","DOI":"10.1210\/jendso\/bvab048.1227","article-title":"Pleurihormonal pituitary adenomas presenting as acromegaly","volume":"5","author":"Schwehr","year":"2021","journal-title":"J Endocr Soc"},{"key":"2025082709273079000_15.11.e251451.4","first-page":"130026","article-title":"Pasireotide therapy in a rare and unusual case of plurihormonal pituitary macroadenoma","volume":"2013","author":"Rajendran","year":"2013","journal-title":"Endocrinol Diabetes Metab Case Rep"},{"key":"2025082709273079000_15.11.e251451.5","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.2169\/internalmedicine.4663-20","article-title":"Successful therapy using pasireotide long-acting release for Cushing's disease merged with biochemical acromegaly","volume":"60","author":"Fukunaga","year":"2021","journal-title":"Intern Med"},{"key":"2025082709273079000_15.11.e251451.6","unstructured":"Pawlikowsyky M . Plurihormonality of pituitary adenomas in light of immunohistochemical studies.. Polish Journal of Endocrinology 2020;61."}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-251451","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:27:41Z","timestamp":1756312061000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-251451"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11]]},"references-count":6,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,11,21]]},"published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1136\/bcr-2022-251451"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-251451","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11]]}}}