{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T22:45:07Z","timestamp":1793832307214,"version":"4.6.1"},"reference-count":56,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T00:00:00Z","timestamp":1685404800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008235","name":"Peking Union Medical College Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008235","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Growth hormone (GH)\/thyroid stimulating hormone (TSH) cosecreting pituitary adenoma (PA) is an exceedingly rare kind of bihormonal pituitary neuroendocrine tumors (PitNETs). Its clinical characteristics have rarely been reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aimed to summarize the clinical characteristics and experience of diagnosis and treatment among patients with mixed GH\/TSH PAs from a single center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed GH\/TSH cosecreting PAs from 2063 patients diagnosed with GH-secreting PAs admitted to Peking Union Medical College Hospital between January 1<jats:sup>st<\/jats:sup>, 2010, and August 30<jats:sup>th<\/jats:sup>, 2022, to investigate the clinical characteristics, hormone detection, imaging findings, treatment patterns and outcomes of follow-up. We further compared these mixed adenomas with age- and sex-matched cases of GH mono-secreting PAs (GHPAs). The data of the included subjects were collected using electronic records from the hospital\u2019s information system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Based on the inclusion and exclusion criteria, 21 GH\/TSH cosecreting PAs were included. The average age of symptom onset was 41.6 \u00b1 14.9 years old, and delayed diagnosis occurred in 57.1% (12\/21) of patients. Thyrotoxicosis was the most common complaint (10\/21, 47.6%). The median inhibition rates of GH and TSH in octreotide suppression tests were 79.1% [68.8%, 82.0%] and 94.7% [88.2%, 97.0%], respectively. All these mixed PAs were macroadenomas, and 23.8% (5\/21) of them were giant adenomas. Comprehensive treatment strategies comprised of two or more therapy methods were applied in 66.7% (14\/21) of patients. Complete remission of both GH and TSH was accomplished in one-third of cases. In the comparison with the matched GHPA subjects, the mixed GH\/TSH group presented with a higher maximum diameter of the tumor (24.0 [15.0, 36.0] mm <jats:italic>vs<\/jats:italic>. 14.7 [10.8, 23.0] mm, P = 0.005), a greater incidence of cavernous sinus invasion (57.1% <jats:italic>vs<\/jats:italic>. 23.8%, P = 0.009) and a greater difficulty of long-term remission (28.6% <jats:italic>vs<\/jats:italic>. 71.4%, P &amp;lt;0.001). In addition, higher occurrence rates of arrhythmia (28.6% <jats:italic>vs<\/jats:italic>. 2.4%, P = 0.004), heart enlargement (33.3% <jats:italic>vs<\/jats:italic>. 4.8%, P = 0.005) and osteopenia\/osteoporosis (33.3% <jats:italic>vs<\/jats:italic>. 2.4%, P = 0.001) were observed in the mixed PA group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There are great challenges in the treatment and management of GH\/TSH cosecreting PA. Early diagnosis, multidisciplinary therapy and careful follow-up are required to improve the prognosis of this bihormonal PA.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2023.1197244","type":"journal-article","created":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T10:28:30Z","timestamp":1685528910000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Clinical features and therapeutic outcomes of GH\/TSH cosecreting pituitary adenomas: experience of a single pituitary 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