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Background: 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. Objectives: 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. Methods: We retrospectively reviewed GH/TSH cosecreting PAs from 2063 patients diagnosed with GH-secreting PAs admitted to Peking Union Medical College Hospital between January 1st, 2010, and August 30th, 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's information system. Results: Based on the inclusion and exclusion criteria, 21 GH/TSH cosecreting PAs were included. The average age of symptom onset was 41.6 ± 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 onethird 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 vs. 14.7 [10.8, 23.0] mm, P = 0.005), a greater incidence of cavernous sinus invasion (57.1% vs. 23.8%, P = 0.009) and a greater difficulty of long-term remission (28.6% vs. 71.4%, P <0.001). In addition, higher occurrence rates of arrhythmia (28.6% vs. 2.4%, P = 0.004), heart enlargement (33.3% vs. 4.8%, P = 0.005) and osteopenia/osteoporosis (33.3% vs. 2.4%, P = 0.001) were observed in the mixed PA group. Conclusion: 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. [ABSTRACT FROM AUTHOR]

Three new species, Pseudocandona cheni sp. nov., Cyclocypris pangi sp. nov., and Tonnacypris rectangularis sp. nov., collected from northern China, are described in this study. Pseudocandona cheni, of the compressa group, is difficult to be distinguished from other members of the same group by carapace morphology alone, but can be readily recognised by the structure of the hemipenis comprised of a long lobe a, distally inflated lobe h, and exteriorly pointed lobe b, as well as thick trunks of the male fifth limb endopodites. Cyclocypris pangi, despite its similarity in carapace morphology to its congeners, can be identified based on the morphology of the hemipenis, which bears a slender, slightly curved lobe h, and an S-shaped process accompanying lobe b, in addition to the rectangular trunk of the male fifth limb endopodite. On the other hand, Tonnacypris rectangularis, described on the basis of females only, can be distinguished from other Tonnacypris Diebel & Pietrzeniuk, 1975 representatives by its distinct sub-rectangular carapace alone. Other differences include the length of the swimming setae, the length of the distal claws on the second antennae, and the morphology of the pincer organ on the seventh limb. This study contributes to the poorly known extant non-marine ostracod fauna of Inner Mongolia and Beijing, and generally to the centraleastern Palaearctic region. In addition, the known distribution range of Tonnacypris is extended eastwardly by T. rectangularis. The valve-morphology data are useful for identifying fossil/sub-fossil representatives. [ABSTRACT FROM AUTHOR]