Arrabal-Polo M A, Jimenez-Pacheco A, Arrabal-Martin M, Moreno-Jimenez J, Gutierrez-Tejero F, Galisteo-Moya R, Zuluaga-Gomez A
Department of Urology, San Cecilio University Hospital, Granada, Spain.
Acta Clin Belg. 2012 May-Jun;67(3):214-6. doi: 10.2143/ACB.67.3.2062658.
This case report describes a case of hyperthyroidism as manifestation of an embryonal carcinoma, and illustrates the causes that led to it. The case describes a 33-year-old male patient who complained of chest pain, palpitations, mild dyspnoea, and weight loss. Blood analysis reveals high levels of human chorionic gonadotropin (833818 mlU/ml), T3 (16.90 pg/ml), and T4 (7.77 ng/dl), as well as a fall of TSH (0.01 ulU/ml). Physical examination and imaging procedures confirm the occurrence of a left testicular tumour associated with numerous lung, hepatic and retroperitoneal metastases. Treatment with carbimazol and propanolol is established to manage hyperthyroidism, and an urgent orchiectomy is performed; the histologic diagnosis confirms an embryonal carcinoma (organoid type), but the patient died unexpectedly 24 hours later after having suffered sudden dyspnoea, tachypnoea, and tachyarrhythmia. Hyperthyroidism is a rare manifestation of a testicular tumour that should be borne in mind with regard to the patient's symptomatology and HCG levels.
本病例报告描述了一例以胚胎性癌为表现的甲状腺功能亢进症病例，并阐述了导致该病症的原因。该病例为一名33岁男性患者，主诉胸痛、心悸、轻度呼吸困难和体重减轻。血液分析显示人绒毛膜促性腺激素水平较高（833818 mIU/ml）、T3（16.90 pg/ml）和T4（7.77 ng/dl），促甲状腺激素水平下降（0.01 μIU/ml）。体格检查和影像学检查证实存在左侧睾丸肿瘤，并伴有多处肺、肝和腹膜后转移。采用卡比马唑和普萘洛尔治疗甲状腺功能亢进症，并紧急实施睾丸切除术；组织学诊断证实为胚胎性癌（类器官型），但患者在出现突发呼吸困难、呼吸急促和快速性心律失常后24小时意外死亡。甲状腺功能亢进症是睾丸肿瘤的一种罕见表现，鉴于患者的症状和人绒毛膜促性腺激素水平，应予以关注。
