Coexisting pituitary lesions may range from clinically non-functioning adenomas to hormonally active tumors such as prolactinomas and growth hormone (GH) or thyrotropin (TSH)-secreting adenomas. A 22-year-old male presented with a two-month history of generalized tonic-clonic seizures, accompanied by signs of intracranial hypertension, including intermittent frontal headaches resistant to analgesics and a sudden decrease in visual acuity. He also reported a 20 kg weight gain and an increase in shoe size from 40 to 44 over a seven-month period, without any decline in libido. Clinical examination revealed normal blood pressure and heart rate, and no dysmorphic features, particularly no acromegaloid characteristics. The patient had moderate obesity (BMI: 34 kg/m²), bilateral gynecomastia, mild violaceous striae, no galactorrhea, and was classified as Tanner stage G5P5. Hormonal evaluation showed hyperprolactinemia at 278 ng/mL, central hypothyroidism (TSH: 0.6 mIU/L; free T4: 8 pmol/L), and central hypogonadism (FSH: 1.37 IU/L; LH: 1.1 IU/L; total testosterone: 1.80 ng/mL). IGF-1 was within the normal range (275.8 ng/mL; reference: 120–338). Morning cortisol was 15 µg/dL, with an appropriate suppression after a 1 mg overnight dexamethasone test (0.7 µg/dL). A 24-hour urinary free cortisol measurement was also normal (75 µg/24h). HbA1c was 5.5%. Ophthalmologic examination revealed a normal fundus, but visual field testing showed nasal isopter narrowing. Pituitary MRI demonstrated a well-defined intra- and suprasellar lesion measuring 19 × 16 × 19 mm, consistent with a pituitary macroadenoma. Additionally, an infiltrative cortical and subcortical lesion in the fronto-cingulate region (36 × 24 × 47 mm) suggested a low-grade glioma. The patient was started on cabergoline 0.5 mg twice weekly and levothyroxine 25 µg daily. Neurosurgical intervention for the glioma was performed with gross total resection. Histopathological analysis confirmed a low-grade glial proliferation. Postoperative clinical and biochemical follow-up showed favorable outcomes. This case highlights the need for comprehensive neuroimaging in patients diagnosed with pituitary adenomas who present with atypical neurological symptoms, such as seizures.