Adrenocorticotropic hormone secreting monohormonal double pituitary microadenomas causing Cushing's disease

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Double pituitary adenomas are rare, and they account only 1%–4% of all pituitary adenomas. Single or multiple adrenocorticotropic hormone (ACTH) producing adenomas are rare; even small adenomas can produce potent endocrinological effects. So far only two case reports mentioning monohormonal ACTH-secreting double adenoma have been reported. Higher resolution magnetic resonance imaging and postcontrast thin T1 spoiled gradient acquisitions can improve detection of these tumors. Surgery should be done with caution, sella should be explored meticulously to assure complete resection of all tumors as many studies have earlier documented high recurrence rates with ACTH adenomas.