[Non-seminomatous testicular cancer presenting with hyperthyroidism]

Area of Science:

• Endocrinology
• Oncology

Background:

• Thyrotoxicosis is a rare hyperthyroid condition.
• Human chorionic gonadotropin (hCG) can induce thyrotoxicosis, particularly with very high levels.
• Gestational hyperthyroidism is a known cause in women.

Purpose of the Study:

• To present a case of hCG-induced thyrotoxicosis in a male patient with non-seminomatous testicular cancer (NSGCT).
• To highlight the association between extremely high hCG levels and thyrotoxicosis in oncology patients.
• To demonstrate the efficacy of chemotherapy in resolving hCG-induced thyrotoxicosis.

Main Methods:

• Case report of a 53-year-old male patient.
• Clinical presentation: fatigue, weight loss, nausea, abdominal distension.
• Laboratory investigations: suppressed TSH, elevated free T4 and T3, markedly elevated hCG (>100,000 IU/L).
• Diagnostic confirmation: NSGCT with extensive metastases.
• Treatment: chemotherapy.

Main Results:

• The patient presented with symptoms of thyrotoxicosis and significantly elevated hCG levels.
• Metastatic non-seminomatous testicular cancer was diagnosed.
• Chemotherapy led to a rapid decrease in hCG levels.
• Thyrotoxicosis symptoms resolved following chemotherapy and reduction in hCG.

Conclusions:

• hCG-induced thyrotoxicosis should be considered in patients with germ cell tumors and very high hCG levels.
• Effective treatment of the underlying malignancy is crucial for normalizing thyroid function.
• This case underscores the importance of monitoring thyroid function in patients with elevated hCG.