{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T13:24:03Z","timestamp":1788269043353,"version":"build-2803163510"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T00:00:00Z","timestamp":1781913600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":73,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"the Key Program of Nature Science Foundation of Anhui Education Committee","award":["2022AH051524"],"award-info":[{"award-number":["2022AH051524"]}]},{"name":"the Key Project of Natural Science Foundation of Bengbu Medical College","award":["2021byzd043"],"award-info":[{"award-number":["2021byzd043"]}]},{"name":"the Postgraduate Scientific Research and Innovation Program of Bengbu Medical College in 2023","award":["Byycx23102"],"award-info":[{"award-number":["Byycx23102"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Thyroid-stimulating hormone (TSH)-secreting pituitary adenoma (TSHoma) is a rare functional pituitary tumor that secretes TSH independently, thus stimulating the synthesis and secretion of thyroid hormone. Its clinical manifestation is central hyperthyroidism, and it is easily misdiagnosed as Graves\u2019 disease. At present, the treatment of TSHoma includes surgery, medication, and radiotherapy, and transsphenoidal pituitary surgery remains the first-line treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>This case involved a 61-year-old Chinese male with clinical manifestations of weight loss, heart palpitations, and shortness of breath, both thyroid hormone and TSH are elevated. The patient was diagnosed with a TSH\/growth hormone (GH) co-secreting pituitary adenoma by serological examination, magnetic resonance imaging of the pituitary gland, and related functional tests. Due to thrombocytopenia and heart disease, the patient was deemed a poor candidate for immediate surgery and was therefore treated with octreotide. Thyroid function tests normalized after medication, and the diagnosis of TSHoma was verified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although TSHoma is rare, it is not difficult to diagnose based on clinical presentation, ancillary examination, and functional testing. Thyroid hormone resistance syndrome is very similar to it and is therefore easily misdiagnosed. Early diagnosis and appropriate treatment can effectively control the disease and even achieve a clinical cure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13256-026-06160-2","type":"journal-article","created":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T10:15:39Z","timestamp":1781950539000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Thyrotropin\/growth hormone co-secreting pituitary adenoma with pancytopenia: a case report"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7339-2401","authenticated-orcid":false,"given":"Jie","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanhui","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Langen","family":"Zhuang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoxi","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Pei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,20]]},"reference":[{"issue":"3","key":"6160_CR1","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1016\/j.ecl.2020.04.002","volume":"49","author":"AF Daly","year":"2020","unstructured":"Daly AF, Beckers A. The epidemiology of pituitary adenomas. Endocrinol Metab Clin North Am. 2020;49(3):347\u201355. https:\/\/doi.org\/10.1016\/j.ecl.2020.04.002.","journal-title":"Endocrinol Metab Clin North Am"},{"issue":"16","key":"6160_CR2","doi-asserted-by":"publisher","first-page":"1386","DOI":"10.1001\/jama.2023.5444","volume":"329","author":"NA Tritos","year":"2023","unstructured":"Tritos NA, Miller KK. Diagnosis and management of pituitary adenomas: a review. JAMA. 2023;329(16):1386\u201398. https:\/\/doi.org\/10.1001\/jama.2023.5444.","journal-title":"JAMA"},{"issue":"6","key":"6160_CR3","doi-asserted-by":"publisher","first-page":"1462","DOI":"10.3171\/2014.7.JNS1471","volume":"121","author":"S Yamada","year":"2014","unstructured":"Yamada S, Fukuhara N, Horiguchi K, Yamaguchi-Okada M, Nishioka H, Takeshita A, et al. Clinicopathological characteristics and therapeutic outcomes in thyrotropin-secreting pituitary adenomas: a single-center study of 90 cases. J Neurosurg. 2014;121(6):1462\u201373. https:\/\/doi.org\/10.3171\/2014.7.JNS1471.","journal-title":"J Neurosurg"},{"issue":"5","key":"6160_CR4","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1016\/j.beem.2009.05.006","volume":"23","author":"P Beck-Peccoz","year":"2009","unstructured":"Beck-Peccoz P, Persani L, Mannavola D, Campi I. Pituitary tumours: TSH-secreting adenomas. Best Pract Res Clin Endocrinol Metab. 2009;23(5):597\u2013606. https:\/\/doi.org\/10.1016\/j.beem.2009.05.006.","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"issue":"4","key":"6160_CR5","doi-asserted-by":"publisher","DOI":"10.1530\/ETJ-22-0223","volume":"12","author":"C Mo","year":"2023","unstructured":"Mo C, Chen H, Zhang Q, Guo Y, Zhong L. Central hyperthyroidism combined with Graves\u2019 disease: case series and review of the literature. Eur Thyroid J. 2023;12(4): e220223. https:\/\/doi.org\/10.1530\/ETJ-22-0223.","journal-title":"Eur Thyroid J"},{"issue":"12","key":"6160_CR6","doi-asserted-by":"publisher","first-page":"1401","DOI":"10.1007\/s40618-019-01066-x","volume":"42","author":"P Beck-Peccoz","year":"2019","unstructured":"Beck-Peccoz P, Giavoli C, Lania A. A 2019 update on TSH-secreting pituitary adenomas. J Endocrinol Invest. 2019;42(12):1401\u20136. https:\/\/doi.org\/10.1007\/s40618-019-01066-x.","journal-title":"J Endocrinol Invest"},{"issue":"1","key":"6160_CR7","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1007\/s12022-015-9395-2","volume":"27","author":"BD Pereira","year":"2016","unstructured":"Pereira BD, Raimundo L, Mete O, Oliveira A, Portugal J, Asa SL. Monomorphous plurihormonal pituitary adenoma of Pit-1 lineage in a giant adolescent with central hyperthyroidism. Endocr Pathol. 2016;27(1):25\u201333. https:\/\/doi.org\/10.1007\/s12022-015-9395-2.","journal-title":"Endocr Pathol"},{"issue":"1","key":"6160_CR8","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1016\/j.ecl.2007.10.001","volume":"37","author":"P Beck-Peccoz","year":"2008","unstructured":"Beck-Peccoz P, Persani L. Thyrotropinomas. Endocrinol Metab Clin North Am. 2008;37(1):123\u2013ix. https:\/\/doi.org\/10.1016\/j.ecl.2007.10.001.","journal-title":"Endocrinol Metab Clin North Am"},{"issue":"2","key":"6160_CR9","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1159\/000351007","volume":"2","author":"P Beck-Peccoz","year":"2013","unstructured":"Beck-Peccoz P, Lania A, Beckers A, Chatterjee K, Wemeau JL. 2013 European thyroid association guidelines for the diagnosis and treatment of thyrotropin-secreting pituitary tumors. Eur Thyroid J. 2013;2(2):76\u201382. https:\/\/doi.org\/10.1159\/000351007.","journal-title":"Eur Thyroid J"},{"issue":"4","key":"6160_CR10","doi-asserted-by":"publisher","first-page":"R183","DOI":"10.1530\/EJE-16-1029","volume":"177","author":"A Tj\u00f6rnstrand","year":"2017","unstructured":"Tj\u00f6rnstrand A, Nystr\u00f6m HF. Diagnosis of endocrine disease: diagnostic approach to TSH-producing pituitary adenoma. Eur J Endocrinol. 2017;177(4):R183\u201397. https:\/\/doi.org\/10.1530\/EJE-16-1029.","journal-title":"Eur J Endocrinol"},{"key":"6160_CR11","doi-asserted-by":"publisher","DOI":"10.1016\/j.mce.2022.111679","volume":"553","author":"B Yao","year":"2022","unstructured":"Yao B, Yang C, Pan C, Li Y. Thyroid hormone resistance: mechanisms and therapeutic development. Mol Cell Endocrinol. 2022;553: 111679. https:\/\/doi.org\/10.1016\/j.mce.2022.111679.","journal-title":"Mol Cell Endocrinol"},{"issue":"7","key":"6160_CR12","doi-asserted-by":"publisher","first-page":"2511","DOI":"10.1210\/jc.2014-3994","volume":"100","author":"X Teng","year":"2015","unstructured":"Teng X, Jin T, Brent GA, Wu A, Teng W, Shan Z. A patient with a thyrotropin-secreting microadenoma and resistance to thyroid hormone (P453T). J Clin Endocrinol Metab. 2015;100(7):2511\u20134. https:\/\/doi.org\/10.1210\/jc.2014-3994.","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"6160_CR13","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1097\/ANA.0000000000000325","volume":"29","author":"MW Dyer","year":"2017","unstructured":"Dyer MW, Gnagey A, Jones BT, Pula RD, Lanier WL, Atkinson JLD, et al. Perianesthetic management of patients with thyroid-stimulating hormone-secreting pituitary adenomas. J Neurosurg Anesthesiol. 2017;29(3):341\u20136. https:\/\/doi.org\/10.1097\/ANA.0000000000000325.","journal-title":"J Neurosurg Anesthesiol"},{"issue":"1","key":"6160_CR14","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1507\/endocrj.EJ14-0118","volume":"62","author":"N Fukuhara","year":"2015","unstructured":"Fukuhara N, Horiguchi K, Nishioka H, Suzuki H, Takeshita A, Takeuchi Y, et al. Short-term preoperative octreotide treatment for TSH-secreting pituitary adenoma. Endocr J. 2015;62(1):21\u20137. https:\/\/doi.org\/10.1507\/endocrj.EJ14-0118.","journal-title":"Endocr J"},{"issue":"3","key":"6160_CR15","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1007\/s12020-016-0863-3","volume":"52","author":"FG Amlashi","year":"2016","unstructured":"Amlashi FG, Tritos NA. Thyrotropin-secreting pituitary adenomas: epidemiology, diagnosis, and management. Endocrine. 2016;52(3):427\u201340. https:\/\/doi.org\/10.1007\/s12020-016-0863-3.","journal-title":"Endocrine"},{"issue":"11","key":"6160_CR16","doi-asserted-by":"publisher","first-page":"1131","DOI":"10.1507\/endocrj.ej14-0278","volume":"61","author":"S Fujio","year":"2014","unstructured":"Fujio S, Ashari HM, Yamahata H, Moinuddin FM, Bohara M, et al. Thyroid storm induced by TSH-secreting pituitary adenoma: a case report. Endocr J. 2014;61(11):1131\u20136. https:\/\/doi.org\/10.1507\/endocrj.ej14-0278.","journal-title":"Endocr J."},{"key":"6160_CR17","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2020.105865","volume":"195","author":"E Thodou","year":"2020","unstructured":"Thodou E, Kontogeorgos G. Somatostatin receptor profile in pituitary thyrotroph adenomas. Clin Neurol Neurosurg. 2020;195: 105865. https:\/\/doi.org\/10.1016\/j.clineuro.2020.105865.","journal-title":"Clin Neurol Neurosurg"},{"issue":"1","key":"6160_CR18","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1210\/en.2013-1683","volume":"155","author":"S Peineau","year":"2014","unstructured":"Peineau S, Guimiot F, Csaba Z, Jacquier S, Fafouri A, Schwendimann L, et al. Somatostatin receptors type 2 and 5 expression and localization during human pituitary development. Endocrinology. 2014;155(1):33\u20139. https:\/\/doi.org\/10.1210\/en.2013-1683.","journal-title":"Endocrinology"},{"issue":"3","key":"6160_CR19","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1046\/j.1365-2265.2002.01549.x","volume":"57","author":"G Blackhurst","year":"2002","unstructured":"Blackhurst G, Strachan MW, Collie D, Gregor A, Statham PF, Seckl JE. The treatment of a thyrotropin-secreting pituitary macroadenoma with octreotide in twin pregnancy. Clin Endocrinol (Oxf). 2002;57(3):401\u20134. https:\/\/doi.org\/10.1046\/j.1365-2265.2002.01549.x.","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"8","key":"6160_CR20","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1089\/thy.2015.0041","volume":"25","author":"F Rimareix","year":"2015","unstructured":"Rimareix F, Grunenwald S, Vezzosi D, Rivi\u00e8re LD, Bennet A, Caron P. Primary medical treatment of thyrotropin-secreting pituitary adenomas by first-generation somatostatin analogs: a case study of seven patients. Thyroid. 2015;25(8):877\u201382. https:\/\/doi.org\/10.1089\/thy.2015.0041.","journal-title":"Thyroid"},{"issue":"6","key":"6160_CR21","doi-asserted-by":"publisher","first-page":"2849","DOI":"10.1210\/jcem.86.6.7593","volume":"86","author":"P Caron","year":"2001","unstructured":"Caron P, Arlot S, Bauters C, Chanson P, Kuhn JM, Pugeat M, et al. Efficacy of the long-acting octreotide formulation (octreotide-LAR) in patients with thyrotropin-secreting pituitary adenomas. J Clin Endocrinol Metab. 2001;86(6):2849\u201353. https:\/\/doi.org\/10.1210\/jcem.86.6.7593.","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"6160_CR22","doi-asserted-by":"publisher","DOI":"10.1186\/s13046-014-0056-y","volume":"33","author":"Y Wang","year":"2014","unstructured":"Wang Y, Li J, Tohti M, Hu Y, Wang S, Li W, et al. The expression profile of Dopamine D2 receptor, MGMT and VEGF in different histological subtypes of pituitary adenomas: a study of 197 cases and indications for the medical therapy. J Exp Clin Cancer Res. 2014;33(1): 56. https:\/\/doi.org\/10.1186\/s13046-014-0056-y.","journal-title":"J Exp Clin Cancer Res"},{"issue":"6","key":"6160_CR23","doi-asserted-by":"publisher","first-page":"2069","DOI":"10.1210\/jc.2013-4376","volume":"99","author":"E Malchiodi","year":"2014","unstructured":"Malchiodi E, Profka E, Ferrante E, Sala E, Verrua E, Campi I, et al. Thyrotropin-secreting pituitary adenomas: outcome of pituitary surgery and irradiation. J Clin Endocrinol Metab. 2014;99(6):2069\u201376. https:\/\/doi.org\/10.1210\/jc.2013-4376.","journal-title":"J Clin Endocrinol Metab"},{"issue":"9","key":"6160_CR24","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1056\/NEJMra042972","volume":"352","author":"DS Cooper","year":"2005","unstructured":"Cooper DS. Antithyroid drugs. N Engl J Med. 2005;352(9):905\u201317. https:\/\/doi.org\/10.1056\/NEJMra042972.","journal-title":"N Engl J Med"},{"issue":"5","key":"6160_CR25","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1111\/j.1365-2265.2008.03382.x","volume":"70","author":"AG Gianoukakis","year":"2009","unstructured":"Gianoukakis AG, Leigh MJ, Richards P, et al. Characterization of the anaemia associated with Graves\u2019 disease. Clin Endocrinol (Oxf). 2009;70(5):781\u20137. https:\/\/doi.org\/10.1111\/j.1365-2265.2008.03382.x.","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"3","key":"6160_CR26","doi-asserted-by":"publisher","first-page":"195","DOI":"10.3109\/08916939708994741","volume":"26","author":"S Hayashi","year":"1997","unstructured":"Hayashi S, Kiyokawa T, Aochi H, et al. Characterization of elevated neutrophil-associated IgG in various autoimmune disorders: not anti-neutrophil autoantibodies, but possibly immune complexes, bind to neutrophils. Autoimmunity. 1997;26(3):195\u2013203. https:\/\/doi.org\/10.3109\/08916939708994741.","journal-title":"Autoimmunity"},{"issue":"3","key":"6160_CR27","doi-asserted-by":"publisher","first-page":"478","DOI":"10.4103\/2230-8210.95739","volume":"16","author":"S Raina","year":"2012","unstructured":"Raina S, Kaul R, Mruthyunjaya M. Pancytopenia with cellular bone marrow related to Graves\u2019 hyperthyroidism. Indian J Endocrinol Metab. 2012;16(3):478\u20139. https:\/\/doi.org\/10.4103\/2230-8210.95739.","journal-title":"Indian J Endocrinol Metab"},{"issue":"6","key":"6160_CR28","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1046\/j.1365-2257.2002.00460.x","volume":"24","author":"B Shaw","year":"2002","unstructured":"Shaw B, Mehta AB. Pancytopenia responding to treatment of hyperthyroidism: a clinical case and review of the literature. Clin Lab Haematol. 2002;24(6):385\u20137. https:\/\/doi.org\/10.1046\/j.1365-2257.2002.00460.x.","journal-title":"Clin Lab Haematol"},{"issue":"9","key":"6160_CR29","doi-asserted-by":"publisher","first-page":"1159","DOI":"10.1136\/ard.2004.022624","volume":"63","author":"MG Tektonidou","year":"2004","unstructured":"Tektonidou MG, Anapliotou M, Vlachoyiannopoulos P, Moutsopoulos HM. Presence of systemic autoimmune disorders in patients with autoimmune thyroid diseases. Ann Rheum Dis. 2004;63(9):1159\u201361. https:\/\/doi.org\/10.1136\/ard.2004.022624.","journal-title":"Ann Rheum Dis"}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-026-06160-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-026-06160-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-026-06160-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T13:11:14Z","timestamp":1788268274000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s13256-026-06160-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,20]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["6160"],"URL":"https:\/\/doi.org\/10.1186\/s13256-026-06160-2","relation":{},"ISSN":["1752-1947"],"issn-type":[{"value":"1752-1947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,20]]},"assertion":[{"value":"16 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Our institution does not require ethical approval for the case report. Informed consent was obtained from the participant.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no competing interests related to this work.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"513"}}