According to clinical practice (4) and to European Society of Endocrinology (ESE) guidelines (5), GH-PitNET/adenomas are defined as aggressive if, invasive, with a high proliferative index, with refractory behavior and poor response to optimal standard treatments such as surgical, medical, and radiotherapy, and in cases of multiple local recurrences (5, 6). The gene discussed is GH1; the disease is adenoma.