{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:16:57Z","timestamp":1784557017728,"version":"3.55.0"},"reference-count":39,"publisher":"Bioscientifica","issue":"1","license":[{"start":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T00:00:00Z","timestamp":1732060800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"crossref","award":["314061271-TRR\/CRC 205"],"award-info":[{"award-number":["314061271-TRR\/CRC 205"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["ec.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,11,20]]},"abstract":"<jats:p>\n                    Human chorionic gonadotropin (hCG) has structural similarities with thyroid-stimulating hormone (TSH) and may stimulate TSH receptors at higher concentrations. During pregnancy, placental hCG causes TSH suppression, contributing to hyperemesis. However, in males, clinical manifestations caused by excess hCG are rare. Herein, we describe complications of life-threatening thyroid storm caused by paraneoplastic hCG secretion from testicular germ cell tumours (GCTs) and aim to identify high-risk groups through retrospective analysis in\n                    <jats:italic>n<\/jats:italic>\n                    = 20 males (aged 17\u201355 years) with testicular hCG-positive GCTs. Seven hCG-positive testicular GCTs were classified as seminoma, and 13 were classified as non-seminomatous GCTs (NSGCTs). In 3\/7 males with seminomas (43%), serum \u03b2-hCG concentrations were mildly elevated (median: 0.3 U\/L; range: 0.3\u201382.1 U\/L). In contrast, \u03b2-hCG was increased in 12\/13 (92%) males with a NSGCT (median: 71.1 U\/L; range: 0.3\u20131,600,000 U\/L). In 10\/13 males with NSGCT (77%), we detected components of embryonal cell carcinoma (EC), and in 7\/13 (54%), we detected components of a choriocarcinoma (ChC). TSH was suppressed with high free thyroxine levels in two cases with NSGCT and excessively elevated \u03b2-hCG concentrations, but there was no TSH suppression in a further case with high \u03b2-hCG. One patient with NSGCT and high \u03b2-hCG levels presented with thyroid storm and imminent decompensation refractory to anti-thyroid treatment, requiring a total thyroidectomy. In the second patient, anti-thyroid treatment was initiated shortly after the diagnosis, successfully normalizing hyperthyroxinaemia. In conclusion, paraneoplastic \u03b2-hCG production, occurring in NSGCTs with components of ECs or ChCs, is a rare cause of thyrotoxicosis. Early recognition and treatment are critical to prevent a life-threatening thyroid storm.\n                  <\/jats:p>","DOI":"10.1530\/ec-24-0341","type":"journal-article","created":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T11:06:30Z","timestamp":1732100790000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-10","source":"Crossref","is-referenced-by-count":2,"title":["Hyperthyroidism induced by paraneoplastic human chorionic gonadotropin (hCG) production from testicular tumours: a retrospective clinical and histopathological study"],"prefix":"10.1530","volume":"14","author":[{"given":"Julia","family":"Rohayem","sequence":"first","affiliation":[{"name":"Centre of Reproductive Medicine and Andrology, University Hospital M\u00fcnster, M\u00fcnster, Germany"},{"name":"Children\u2019s Hospital of Eastern Switzerland, St. Gallen, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9181-3995","authenticated-orcid":true,"given":"Jan","family":"Idkowiak","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Systems Science, College of Medicine and Health, University of Birmingham, Birmingham, United Kingdom"},{"name":"Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, University of Birmingham, Birmingham, United Kingdom"},{"name":"Department of Endocrinology and Diabetes, Birmingham Children\u2019s Hospital, Birmingham Women\u2019s and Children\u2019s NHS Foundation Trust, Birmingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Huss","sequence":"additional","affiliation":[{"name":"Institute of Pathology, University Hospital M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Balke","sequence":"additional","affiliation":[{"name":"Centre of Reproductive Medicine and Andrology, University Hospital M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendrik","family":"Sch\u00fcrmann","sequence":"additional","affiliation":[{"name":"Institute of Pathology, University Hospital M\u00fcnster, M\u00fcnster, Germany"},{"name":"Department of Medical Oncology, University Hospital Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birthe","family":"Heitk\u00f6tter","sequence":"additional","affiliation":[{"name":"Institute of Pathology, University Hospital M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Wistuba","sequence":"additional","affiliation":[{"name":"Centre of Reproductive Medicine and Andrology, University Hospital M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Huebner","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital, Universit\u00e4tsklinikum Carl Gustav Carus Dresden, Technische Universit\u00e4t Dresden, Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"New Engl J Med","first-page":"242","article-title":"Testicular germ-cell cancer","volume":"337","author":"Bosl GJ","year":"1997","unstructured":"Bosl GJ & Motzer RJ Testicular germ-cell cancer. 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