Thyrotoxicosis From Molar Thyrotropin

Clinical endocrine syndromes resulting from production of polypeptide hormones by ectopic tumors have become increasingly well recognized. 1 Since the report of Dowling et al 2 in 1960, particular attention has been directed to disorders of thyroid function related to ectopic hormonal secretions. These investigators described three patients with hydatidiform moles whohad laboratory evidence consistent with hyperthyroidism. A year later, Myers 3 described a woman with metastatic choriocarcinoma who appeared euthyroid but whose laboratory values were consistent with thyrotoxicosis. Odell et al, 4 in 1963, described seven of a series of 93 patients with metastatic choriocarcinoma who had elevated thyroidal radioiodine uptakes, increased serum levels of protein-bound iodine (PBI), and increased basal metabolic rates (BMR) despite the clinical appearance of only minimal hypermetabolism and absence of goiter. These reports established the syndrome of eumetabolic hyperthyroidism associated with biologically active trophoblastic tumors. This syndrome recently was reexamined in detail, and the