Hyperthyroidism in non-seminomatous testicular germ cell tumors: two case reports and literature review

BackgroundHuman chorionic gonadotropin (hCG)–induced hyperthyroidism is a rare paraneoplastic syndrome observed in non-seminomatous testicular germ cell tumors, due to a cross-reaction between the β-subunit of hCG with the thyroid-stimulating hormone receptor. The precise prevalence of this paraneop...

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Bibliographic Details
Main Authors: Diletta Favero, Christoph Oing, Christoph Seidel, Pasquale Rescigno, Fabio Catalano, Malvina Cremante, Sara Elena Rebuzzi, Federico Gatto, Giovanni Rosti, Diego Ferone, Giuseppe Fornarini, Francesco Cocchiara
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-03-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2024.1338438/full
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Summary:BackgroundHuman chorionic gonadotropin (hCG)–induced hyperthyroidism is a rare paraneoplastic syndrome observed in non-seminomatous testicular germ cell tumors, due to a cross-reaction between the β-subunit of hCG with the thyroid-stimulating hormone receptor. The precise prevalence of this paraneoplastic phenomenon is unclear as, in the majority of cases, hyperthyroidism remains subclinical.Case presentationHere, we present two cases of advanced metastatic non-seminomatous testicular germ cell tumors where patients exhibited signs and symptoms of thyrotoxicosis at primary diagnosis due to excessive serum β-hCG elevation, with complete remission of symptomatology after the start of oncological treatments and no signs of relapse at the time of publication of this report. Additionally, we provide a comprehensive review of the existing literature concerning this uncommon occurrence.ConclusionDespite being a rare event, the presence of hyperthyroidism or thyrotoxicosis without clear etiology in a young man should lead to consider less frequent causes such as testicular tumors. Even if patients typically have mild symptoms that resolve after chemotherapy, in rare cases, it can be a life-threatening condition that requires prompt recognition and specific intervention.
ISSN:2234-943X