Table 3.

Case reports of TSHoma combined with GD.

	Authors	Year	Country	Age/gender	Clinical process	Clinical manifestations	TSH (μIU/mL)	Dmax (mm)	Treatment measures	Management and follow-up
1	O’Donnel et al. (10)	1973	UK	25/M	TSHoma→GD	Thyrotoxicosis signs, scant hair growth, impairment of peripheral vision	28	N/A	Cortisol, testosterone, ATD, thyroxine, hypophysectomy	Recurrent hyperthyroidism, recovered after ATD treatment
2	Sandler et al. (11)	1976	USA	56/F	GD complicated with TSHoma	Thyrotoxicosis signs, symptomatic ophthalmopathy, and acromegaly	8.1	N/A	ATD, pituitary irradiation, propranolol, radioiodine therapy, cortisone	Recurrent hyperthyroidism several times, intermittent ATD treatment, TSH levels at or below detectable limits
3	Yovos et al. (12)	1981	USA	17/F	GD complicated with TSHoma	Thyrotoxicosis signs, unilateral exophthalmos, and goiter	52.3	N/A	ATD, propranolol, iodides, steroids, craniotomy, cranial and orbital irradiation	Hyperthyroidism improved, taking only propranolol
4	Kamoi et al. (13)	1985	Japan	46/F	TSHoma→GD	Thyrotoxicosis signs, goiter, and galactorrhoea	15.5	N/A	ATD, prednisolone, TSS	Discontinuation of ATD-induced recurrent hyperthyroidism without evidence of regrowth of the tumor
5	Koriyama et al. (14)	2004	Japan	31/F	TSHoma→GD	Thyrotoxicosis signs and goiter	2.1	N/A	Octreotide and L-T4, ATD, TSS (twice)	Discontinue treatment due to financial reasons and the absence of severe thyrotoxic symptoms
6	Kageyama et al. (15)	2007	Japan	21/F	TSHoma→GD	Thyrotoxicosis signs	3.16	10	TSS	Recurrent hyperthyroidism
7	Lee & Wang (16)	2010	China	27/M	GD→TSHoma	Thyrotoxicosis signs and goiter	<0.004	10.4	ATD	Recurrent hyperthyroidism, refused surgery and continued ATD treatment
8	Lee & Wang (16)	2010	China	28/F	GD→TSHoma	Thyrotoxicosis signs and goiter	0.123	15	ATD	TSH was normal, but FT4 was still high, refused surgery
9	Ogawa & Tominaga (17)	2013	Japan	32/F	GD→TSHoma	Thyrotoxicosis signs	Less than detectable	5	ATD, TSS	Recovery
10	Kamoun et al. (18)	2013	France	36/F	GD→TSHoma	Thyrotoxicosis signs, goiter, and exophthalmos	1.2–1.8	10	ATD, propranolol, thyroid lobectomy, lanreotide, TSS	Recovery
11	Okuyucu et al. (19)	2016	Turkey	37/F (pregnant)	GD complicated with TSHoma	Thyrotoxicosis signs, goiter, and exophthalmos	5.54	13	ATD, thyroidectomy, TSS	N/A
12	Arai et al. (20)	2017	Japan	40/F	GD complicated with TSHoma	Headache and exophthalmos	0.27	13	ATD, TSS	Recovery
13	Li et al. (21)	2018	China	55/M	GD complicated with TSHoma	Recurrent atrial fibrillation and thyrotoxicosis signs	8.9	23	ATD, TSS	Tumor recurrence and thyroid function tests remained clinically acceptable, remained ATD treatment
14	Campi et al. (22)	2020	Italy	36/N/A	interf→TSHoma→GD	Thyrotoxicosis signs	1.290	N/A	SMS-LAR, ATD	Recurrent hyperthyroidism after ATD was discontinued, while TSH levels were normal
15	Fu et al. (23)	2020	China	55/F	GD complicated with TSHoma	Thyrotoxicosis signs and goiter	0.337	17	Propranolol, TSS, ATD (postoperative)	TSH below normal range, continued ATD therapy
16	Quinn et al. (24)	2020	Ireland	68/F	GD→TSHoma	asymptomatic	<0.02	N/A	ATD, beta-adrenergic blocker	Declined pituitary surgery, managed with a beta-adrenergic blocker and was clinically euthyroid
17	Case 1	2022	China	26/F	GD complicated with TSHoma	Thyrotoxicosis signs, headache, exophthalmos, and goiter	2.407	17	Propranolol, metoprolol, octreotide, ATD, TSS	Thyroid function was normal, TRAb was still positive, continued ATD treatment
18	Case 2	2022	China	47/F	GD complicated with TSHoma	Thyrotoxicosis signs, headache, hypopsia, and goiter	6.854	18	Metoprolol, octreotide, TSS	Recurrence of hyperthyroidism and tumor, refusal of SMS-LAR, secondary surgery, or radiation therapy for financial reasons, continued metoprolol treatment
19	Case 3	2022	China	45/F	TSHoma→GD	Thyrotoxicosis signs and amenorrhea	4.73	20	Propranolol, octreotide, TSS, bromocriptine, metoprolol, gamma-knife	Recurrence of hyperthyroidism and tumor, treated with metoprolol, bromocriptine, and gamma-knife

ATD, antithyroid drugs; Dmax, maximum diameter of pituitary adenomas; F, female; FT4, free thyroxine; GD, Graves' disease; L-T4, levothyroxine; M, man; N/A, not available; SMS-LAR, long-acting-release somatostatin analog; TRAb, thyroid-stimulating hormone receptor antibodies; TSH, thyroid-stimulating hormone; TSHoma, thyroid-stimulating hormone-secreting pituitary adenoma; TSS, transsphenoidal surgery.