Relatamos o caso de uma gestante de 26 anos apresentando episódios de sangramento vaginal, perda ponderal e dispnéia, que recebeu o diagnóstico de coriocarcinoma com metástases pulmonares. O nível de gonadotrofina coriônica (hCG) era >2,5 x 10(6)mU/mL. O TSH era de 0,037mU/L (0,49 - 4,67), o T4 de 18,1ug/dL (4,9 - 10,7), e o T3 de 136ng/dL (45 - 137), confirmando o quadro de hipertireoidismo subclínico induzido pela hCG. A paciente foi submetida a um regime combinado de quimioterapia com etoposídeo, metotrexate e dactiomicina. A evolução inicial foi complicada por um quadro de urosepsis com insuficiência respiratória, necessitando entubação endotraqueal por 3 dias. Após, houve melhora progressiva com normalização dos testes de função tireoideana no 12º dia de internamento. Após 6 meses e 10 ciclos de quimioterapia, a paciente estava em remissão e sem sinais de tumor residual ou de atividade paraneoplásica dependente de hCG.
A 26-year-old pregnant woman presenting with repeated episodes of vaginal bleeding, weight loss, and shortness of breath was diagnosed with choriocarcinoma with metastases to both lungs. Chorionic gonadotropin levels (hCG) were >2.5 x 10(6)mU/mL. Consistent with hCG-induced subclinical hyperthyroidism, she had a suppressed TSH of 0.037mU/L (0.49 - 4.67), a T4 of 18.1µg/dL (4.9 - 10.7), and T3 of 136ng/dL (45 - 137). Chemotherapy with a combined regimen with etoposide, methotrexate, and dactinomycine was started. The initial course was complicated by urosepsis with respiratory distress requiring endotracheal intubation for 3 days. She then improved rapidly, and her thyroid function tests were within normal limits by day 12. Six months later, after ten cycles of chemotherapy, the patient was in remission without signs of residual tumor or hCG-induced paraneoplastic activity.
