Only several driver mutations have been identified to date in PAs, including guanine nucleotide-binding protein subunit alpha S (GNAS) in somatotroph adenomas3 and ubiquitin-specific protease 8 (USP8), USP48 and B-Raf proto-oncogene (BRAF) in corticotroph adenomas4,5. This evidence concerns the gene USP8 and gonorrhea.