Hyperthyroidism in men with germ cell tumors and high levels of beta‐human chorionic gonadotropin

Sergio A. Giralt, Francisco Dexeus, Robert Amato, Avishay Sella, Christopher Logothetis

Research output: Contribution to journalArticlepeer-review

Abstract

A retrospective review was done on ail high volume choriocarcinomas and other germ cell tumors of men with serum beta‐human chorionic gonadotropin (beta‐HCG) levels greater than 50,000 mIU/ml to determine the incidence and characteristics of hyperthyroidism in this setting. Nineteen patients were identified with high beta‐HCG levels, but because 2 did not have thyroid function tests performed, the cases of only 17 patients were evaluable. Of these, 14 (82%) had primary testicular carcinoma and 3 (18%) had extragonadal tumors. Beta‐HCG levels on presentation ranged from 80,000 to 3,058,000 mIU/ml, with a median of 243,500 mIU/ml. Seven of the 17 evaluable cases (41%) had T4 serum levels higher than 12 μg/dl (normal level 4 to 12 μg/dl) with a median value of 15.4 μg/dl (range, 12.6 to 33.5 μg/dl); serum T4 levels correlated with beta‐HCG levels (r = 0.84). All seven patients with elevated T4 levels had beta‐HCG values greater than 200,000 mIU/ml, and three of these seven had clinical manifestations that could be attributed to an elevated serum T4; only one patient required specific antithyroid treatment; and after control of primary disease, all other patients had normalization of thyroid function. The most common manifestations of hyperthyroidism in our series were tachycardia, hypertension, and a systolic flow murmur; none of the patients had thyroid gland enlargement, We conclude that subclinical hyperthyroidism is a relatively common phenomenon in germ cell tumors of men with high levels of beta‐HCG and that control of the primary disease results in serum T4 level normalization.

Original languageEnglish
Pages (from-to)1286-1290
Number of pages5
JournalCancer
Volume69
Issue number5
DOIs
StatePublished - 1 Mar 1992
Externally publishedYes

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