Double functional
pituitary adenomas are rare, and only a few cases of excessive clinical symptoms of both
adrenocorticotropic hormone(
ACTH)and
growth hormone(GH)have been reported. We herein report a case of symptomatic
ACTH-and GH-producing double
pituitary adenomas, which were discretely located within the same pituitary gland. A 38-year-old woman presented with general malaise, facial and lower limb
edema, unexplained
weight gain, facial redness,
acne, and nasal enlargement. Endocrinological findings matched with the diagnostic criteria for both
acromegaly and
Cushing's disease. Preoperative magnetic resonance imaging showed a 15-mm
cyst-like lesion on the right side of the sellae surrounded by what was thought to be the normal contrast-enhancing pituitary gland. We assumed that the
cyst-like lesion was an
adenoma and performed endoscopic endonasal transsphenoidal surgery. However, the
cyst-like lesion was a parenchymal
tumor. Furthermore, the region we considered to be a normal pituitary gland was also found to be an
adenoma. Both
adenomas were completely resected. The postoperative blood analysis showed
ACTH<1.0pg/dL,
cortisol 1.8μg/dL, and
insulin-like growth factor-1 60ng/mL, all of which were below reference levels. The histopathological examination confirmed the coexistence of two
adenomas, a GH-producing
adenoma and an
ACTH-producing
adenoma. We concluded that these
adenomas were endocrinologically active within the pituitary gland. Thus, a diagnosis of double
pituitary adenomas was made. When treating a patient with symptoms caused by hypersecretion of multiple
anterior pituitary hormones, the possibility of coexisting multiple
pituitary adenomas should be considered.