This study investigates the clinicopathological, molecular, and clinical features of pituitary neuroendocrine tumors (PitNETs) with co-expression of PIT1 and SF1, which are typically classified as "plurihormonal" according to the current WHO 2022 classification. The authors compiled an in-house case series of 100 tumors previously diagnosed as somatotroph PitNETs and found that 74% of densely granulated somatotroph PitNETs (DGST) co-expressed PIT1 and SF1 (DGST-PIT1/SF1). In contrast, none of the sparsely granulated somatotroph PitNETs (SGST) stained positive for SF1. Histopathological analysis revealed that DGST-PIT1/SF1 tumors had fewer fibrous bodies and less FSH/LH expression compared to DGST-PIT1 tumors. Molecular analyses, including DNA methylation and copy number profiles, confirmed that DGST-PIT1/SF1, DGST-PIT1, and SGST-PIT1 represent distinct tumor subtypes. Clinicopathological meta-analyses indicated that DGST-PIT1 tumors responded more favorably to treatment with somatostatin analogs compared to DGST-PIT1/SF1 tumors, while both subtypes showed a less aggressive clinical course than SGST-PIT1 tumors. The study highlights the distinct nature of DGST-PIT1/SF1 tumors and calls for a refinement of the WHO classification to better reflect their unique characteristics. The authors propose the term "somatogonadotroph PitNET" for DGST-PIT1/SF1 tumors.This study investigates the clinicopathological, molecular, and clinical features of pituitary neuroendocrine tumors (PitNETs) with co-expression of PIT1 and SF1, which are typically classified as "plurihormonal" according to the current WHO 2022 classification. The authors compiled an in-house case series of 100 tumors previously diagnosed as somatotroph PitNETs and found that 74% of densely granulated somatotroph PitNETs (DGST) co-expressed PIT1 and SF1 (DGST-PIT1/SF1). In contrast, none of the sparsely granulated somatotroph PitNETs (SGST) stained positive for SF1. Histopathological analysis revealed that DGST-PIT1/SF1 tumors had fewer fibrous bodies and less FSH/LH expression compared to DGST-PIT1 tumors. Molecular analyses, including DNA methylation and copy number profiles, confirmed that DGST-PIT1/SF1, DGST-PIT1, and SGST-PIT1 represent distinct tumor subtypes. Clinicopathological meta-analyses indicated that DGST-PIT1 tumors responded more favorably to treatment with somatostatin analogs compared to DGST-PIT1/SF1 tumors, while both subtypes showed a less aggressive clinical course than SGST-PIT1 tumors. The study highlights the distinct nature of DGST-PIT1/SF1 tumors and calls for a refinement of the WHO classification to better reflect their unique characteristics. The authors propose the term "somatogonadotroph PitNET" for DGST-PIT1/SF1 tumors.