ReviewEndocrine2026
Clinical management challenges of Cushing's disease associated with double pituitary adenomas: four cases and literature review.
Review in Endocrine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
13 authors.
Funding
Abstract
purposeTo characterize clinical, radiological, and pathological features of double pituitary adenomas (DPAs) involving a corticotroph adenoma and evaluate challenges associated with preoperative localization and surgical management of Cushing's disease (CD).
methodsWe retrospectively reviewed four institutional cases and searched PubMed and Web of Science (1990-2025), identifying 30 publications comprising 68 additional cases. Demographic, clinical, radiological, immunohistochemical, surgical, and outcome data from the combined cohort were analyzed.
resultsIn all four institutional cases, the lesion removed during initial transsphenoidal surgery (TSS) was a noncorticotroph adenoma, and hypercortisolism persisted. Follow-up pituitary magnetic resonance imaging (MRI) demonstrated a second suspected lesion in all four patients. In Cases 3 and 4, MRI abnormalities were subtle or equivocal, and
conclusionsDPAs involving a corticotroph component should be considered as a possible explanation for persistent hypercortisolism after TSS when the resected lesion is negative for ACTH and T-PIT. Multidisciplinary reassessment and repeat expert pituitary imaging review may help identify an additional lesion. The role of adjunctive molecular imaging remains preliminary.
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