Abstract
Although Graves’ disease continues to be considered the most frequent cause of clinical hyperthyroidism in pregnancy, the disproportionately high production of human chorionic gonadotropin (HCG) as occurs in gestational trophoblastic disease (TSG), is another possible cause, due to analogy between this (HCG) and TSH. We present the case of a 23-year-old patient who complained of pelvic pain of moderate intensity, respiratory symptoms, tachycardia, tremor, asthenia and weight loss; who was diagnosed with metastatic choriocarcinoma to the lung, with associated thyrotoxicosis, requiring chemotherapeutic and antithyroid management. This case is presented, since hyperthyroidism secondary to choriocarcinoma is a rare pathology but it must be diagnosed and treated opportunely since it depends on the patient’s prognosis.
References
2. Padmanabhan LD. Et al., Trophoblastic hyperthyroidism. J Assoc Physicians India. 2003 Oct;51:1011-3.
3. N.S. Horowitz, et al., Placental site trophoblastic tumors and epithelioid trophoblastic tumors: Biology, natural history, and treatment modalities, Gynecol Oncol. 2017 Jan;144(1):208-214.
4. Biscaro A. et al., Diagnosis, classification and treatment of gestational trophoblastic neoplasia, Rev Bras Ginecol Obstet. 2015 Jan; 37(1):42-51.
5. Goldstein DP. et al., Current management of gestational trophoblastic neoplasia. Hematol Oncol Clin North Am. 2012 Feb;26(1):111-31.
6. Devereaux D. et al., Hyperthyroidism and thyrotoxicosis. Emerg Med Clin North Am. 2014 May;32(2):277-92.
7. Singh I. et al., Pathogenesis of Hyperthyroidism. Compr Physiol. 2016 Dec 6;7(1):67-79.
8. Walkington L. et al., Hyperthyroidism and human chorionic gonadotropin production in gestational trophoblastic disease. Br J Cancer. 2011 May 24;104(11):1665-9.
9. Lazarus JH. Thyroid function in pregnancy. Br Med Bull. 2011 Dec 23;97:137-48.
10. Fantz CR. Et al., Thyroid function during pregnancy. Clin Chem. 1999 Dec;45(12):2250-8.
11. Monchek R. et al., Gestational trophoblastic disease: an overview. J Midwifery Women’s Health. 2012 May-Jun;57(3):255-9.
12. Seckl MJ. Et al., Gestational trophoblastic disease. Lancet. 2010 Aug 28;376(9742):717-29.
13. Yeo CP. Et al., Prevalence of gestational thyrotoxicosis in Asian women evaluated in the 8th to 14th weeks of pregnancy: correlations with total and free beta human chorionic gonadotropin. Clin Endocrinol (Oxf). 2001 Sep;55(3):391-8
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