Thyroid Storm Associated with Testicular Choriocarcinoma
  • Julio César Martínez
    Internal Medicine Department, University Hospital “Dr. Gonzalo Valdés”, Universidad Autónoma de Coahuila, Saltillo, Coahuila, Mexico
  • Ernesto Alfonso Ovalle-Zavala
    Faculty of Medicine, Universidad Autónoma de Coahuila, Saltillo, Coahuila, Mexico


Thyroid storm, testicular choriocarcinoma, human chorionic gonadotropin


Thyroid storm is a rare, life-threatening condition that can be caused by various pathologies including serious conditions associated with human chorionic gonadotropin (hCG)-producing tumours.
We present the case of a 17-year-old male patient with a 1-month history of dyspnoea and a 3-day history of palpitations and fever. General examination revealed a left testicular mass. Blood tests revealed ?-hCG >225,000 mIU/ml, thyroid-stimulating hormone (TSH) 0.02 IU/ml, and thyroxine (T4) 19.07 µg/dl. He was admitted with thyroid storm. Treatment with antithyroid drugs and chemotherapy was started, but the patient died on the third day of admission.
This case highlights a rare occurrence of thyroid storm linked to testicular choriocarcinoma, and provides a necessary reminder that, in some instances, hCG at very high levels can exert a thyrotropic effect due to its molecular structure, which is similar to that of TSH.



  • Pallais J, McInnis M, Saylor P, Wu R. Case 38-2015: A 21-year-old man with fatigue and weight loss. N Engl J Med 2015;373(24):2358–2369.

  • Ovalle E, Lizama O. Emergencias tiroideas. In: Halabe J, Mercado M, Nellen H, editors. Tiroides. Guía práctica para el clínico. Mexico: Manual Moderno; 2011, p. 67–81.

  • Yoshimura M, Hershman J. Thyrotropic action of human chorionic gonadotropin. Thyroid 1995;5(5):425–434.

  • Ross DS, Burch HB, Cooper DS, Greenlee MC, Laurberg P, Maia AL, et al. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid 2016;26:1343–1421.

  • Nakamura H, Noh JY, Itoh K, Fukata S, Miyauchi A, Hamada N. Comparison of methimazole and propylthiouracil in patients with hyperthyroidism caused by Graves’ disease. J Clin Endocrinol Metab 2017;92:2157–2162.

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    Published: 2020-07-02
    Issue: 2020: Vol 7 No 10 (view)

    How to cite:
    Martínez JC, Ovalle-Zavala EA. Thyroid Storm Associated with Testicular Choriocarcinoma. EJCRIM 2020;7 doi:10.12890/2020_001754.