Testicular Germ Cell Tumors: Paraneoplastic Syndromes and the Role of Beta-Human Chorionic Gonadotropin

Abstract

Choriocarcinoma syndrome is a rare phenomenon that occurs in male patients with testicular choriocarcinoma. Male patients who have a testicular non-seminomatous germ cell tumor (TNSGCT) with at least partial choriocarcinoma histology, and metastases to the lungs and/or other extragonadal sites, as well as a markedly elevated beta-human chorionic gonadotropin (HCG), have been prone to pulmonary bleeding, hypoxia, and acute respiratory distress syndrome (ARDS). The respiratory complications occur immediately after chemotherapy is administered or, in some cases, spontaneously. Paraneoplastic hyperthyroidism is another entity described in patients with testicular choriocarcinoma, whereby high levels of HCG (typically >50,000 mIU/ml) induce clinical and laboratory characteristics of hyperthyroidism. We present the case of a male patient diagnosed with TNSGCT and found to have both choriocarcinoma syndrome and paraneoplastic hyperthyroidism in the setting of only mildly elevated HCG levels. We compare our case with similar cases published previously while questioning the quantitative role of HCG.

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

“…In Table 3, the 14 cases reported in literature that we found are summarized (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). Patients' age at diagnosis, when reported, ranged from 18 to 58 years.…”

Choriocarcinoma syndrome of primary pulmonary choriocarcinoma after lung lobe resection: A case report and review of the literature

“…Our study includes a literature review of CS cases published from 2012 to 2021. These cases are included in Table 1 [4,[7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. The patients with clinical data in the publications were aged from 8 to 64 years.…”

Choriocarcinoma syndrome of primary pulmonary choriocarcinoma after lung lobe wedge resection: A case report and review of the literature

“…Our study includes a literature review of CS cases published from 2012 to 2021. These cases are included in Table 1[6, [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. The patients with clinical data in the publications were aged from 8 to 64 years.…”