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Published on: April 17, 2013
Thyroid Storm Associated with Testicular Choriocarcinoma
Julio César Martínez-Gallegos1, Ernesto Alfonso Ovalle-Zavala2
1Internal Medicine Department, University Hospital "Dr. Gonzalo Valdés", Universidad Autónoma de Coahuila, Saltillo, Coahuila, Mexico.
Abstract:
Thyroid storm is a rare, life-threatening condition that can be caused by various pathologies including serious conditions associated with human chorionic gonadotropin (hCG)-producing tumours. We present the case of a 17-year-old male patient with a 1-month history of dyspnoea and a 3-day history of palpitations and fever. General examination revealed a left testicular mass. Blood tests revealed β-hCG >225,000 mIU/ml, thyroid-stimulating hormone (TSH) 0.02 IU/ml, and thyroxine (T4) 19.07 μg/dl. He was admitted with thyroid storm. Treatment with antithyroid drugs and chemotherapy was started, but the patient died on the third day of admission. This case highlights a rare occurrence of thyroid storm linked to testicular choriocarcinoma, and provides a necessary reminder that, in some instances, hCG at very high levels can exert a thyrotropic effect due to its molecular structure, which is similar to that of TSH.
Learning Points:
Thyroid storm is rarely associated with testicular choriocarcinoma.Sometimes, human chorionic gonadotropin at very high levels can exert a thyrotropic effect due to its molecular structure, which is similar to that of thyroid-stimulating hormone.The clinical course and management of thyroid storm secondary to testicular choriocarcinoma in a young male is described.
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