The ability to achieve hormonal remission following TSC is often limited by tumor size (i.e., macroadenomas ≥ 10 mm diameter), the degree of extrasellar extension (particularly lateral into the cavernous sinuses), and high preoperative serum GH concentrations (≥45 ng/mL) [7, 16, 20]. Here, GH1 is linked to tuberous sclerosis.