P ituitary adenomas represent the third most common intracranial tumor (15) and are therefore the mainstay of our daily practice. Pituitary surgery can be extremely successul, as we are increasingly able to cure devastating disorders such s Cushing disease and acromegaly. Nonetheless, even in the ra of endoscopy, neuronavigation, and other technologies that ave advanced the boundaries of pituitary surgery, every surgeon s aware of the limits of surgical treatment: interdisciplinary ollaboration is indeed part of every center encountering pituitary athologies. The multidisciplinary approach, which includes at east the endocrinologist and radiotherapist, leads to disease ontrol in many circumstances that cannot be controlled solely by urgery. Unfortunately, however, some situations are still exremely frustrating because young patients, who harbor apparntly benign tumors, escape treatment; once the singular aggresivity of the tumor is evident, not infrequently it is also clear that ur therapeutic chances are already gone: this is the most requent case scenario of pituitary carcinomas, a rare condition, ith approximately 150 cases reported in the literature. In this ssue, Shastri et al. add another patient to the literature.