Human chorionic gonadotropin (hCG)-induced
hyperthyroidism represents a rare paraneoplastic syndrome
in hCG-secreting testicular cancer. In most cases, this hyperthyroidism
remains subclinical. hCG belongs to the familiy
of glycoprotein hormones with structural homology to thyroid-
stimulating hormone (TSH). The thyrotropic potency
and thereby the degree of cross reactivity of hCG is determined
by several factors, such as content of sialic acid or
lack of the C-terminal tail. In the absence of clinical signs of
hyperthyroidism, treatment usually consists of specific antitumor
therapy which will result in normalization of thyroid
function if hCG declines. Where there are clinical signs of
hyperthyroidism, overlapping thyreostatic treatment is recommended.
Case Report: Here, we report of a young man
presenting biochemical signs of hyperthyroidism without
clinical signs at the time of diagnosis of non-seminomatous
germ cell cancer. β-hCG initially exceeded 1,000,000 IU/ml
and declined close to normal at the end of cancer treatment.
Concomitantly, thyroid hormones returned to the normal
range without any thyreostatic therapy. We observed a significant
correlation of β-hCG and thyroid hormones in linear
regression analysis (r2 = 0.98, p< 0.05). A concise overview
of potential mechanisms of hCG-induced hyperthyroidism
in germ cell cancer but also in pregnancy is given and the
case discussed according to the cited literature.
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