{
    "abstract": "Hydatidiform mole is a malignant entity included in the gestational trophoblastic diseases. It usually produces pregnancy hormones such as beta-human chorionic gonadotropin (\u03b2-hCG), which in turn stimulates endogenous thyroid hormone production. We report the case of a high-risk complete invasive hydatidiform mole with pulmonary metastasis and associated paraneoplastic syndrome. The patient is a 30-year-old woman who presented symptoms of pregnancy and metrorrhagia. A uterine mass was detected. Urine \u03b2-hCG was found negative. In serum, 2,662,000 mIU/mL (normal range: <5) was found, together with parameters of severe hyperthyroidism. The patient underwent uterine curettage with diagnostic and therapeutic means. At that precise moment, her pregnancy-like symptoms worsened and she developed restlessness, tachycardia, diaphoresis, dyspnea at rest, and peripheral edema. A scan showed bilateral pulmonary nodules suggestive of metastasis, acute pulmonary edema, and bilateral pleural effusion without signs of pulmonary thromboembolism. At that time, she presented a free T4 of 2.34 ng/dL (normal range: 0.8-1.8 ng/dL), causing a thyroid storm with secondary cardiac dysfunction. The patient was treated with corticosteroid therapy to decrease peripheral conversion of thyroid hormone T4 to active T3. Her symptoms remitted within 8 h. After 48 h, T4 level was 1.2 ng/dL while serum \u03b2-hCG was 80,000 mIU/mL, with a positive urine result. The change in the urine analysis is due to the \"hook effect\" of the reactive test. An effective chemotherapy treatment was started according to the EMA-CO scheme, remaining free of disease at present. Knowing paraneoplastic syndromes is necessary to achieve the best clinical management and to start treatment early.",
    "authors": [
        {
            "affiliation": "Department of Medical Oncology, Cruces University Hospital, Barakaldo, Spain.",
            "firstname": "Pablo",
            "initials": "P",
            "lastname": "Jim\u00e9nez-Labaig"
        },
        {
            "affiliation": "Department of Medical Oncology, Cruces University Hospital, Barakaldo, Spain.",
            "firstname": "Joan Manuel",
            "initials": "JM",
            "lastname": "Ma\u00f1e"
        },
        {
            "affiliation": "Department of Medical Oncology, Cruces University Hospital, Barakaldo, Spain.",
            "firstname": "Mar\u00eda Pilar",
            "initials": "MP",
            "lastname": "Rivero"
        },
        {
            "affiliation": "Department of Medical Oncology, Cruces University Hospital, Barakaldo, Spain.",
            "firstname": "Lara",
            "initials": "L",
            "lastname": "Lombardero"
        },
        {
            "affiliation": "Department of Medical Oncology, Cruces University Hospital, Barakaldo, Spain.",
            "firstname": "Aintzane",
            "initials": "A",
            "lastname": "Sancho"
        },
        {
            "affiliation": "Department of Medical Oncology, Cruces University Hospital, Barakaldo, Spain.",
            "firstname": "Guillermo",
            "initials": "G",
            "lastname": "L\u00f3pez-Vivanco"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2022 by S. Karger AG, Basel.",
    "doi": "10.1159/000524467",
    "journal": "Case reports in oncology",
    "keywords": [
        "Acute pulmonary edema",
        "Hydatidiform mole",
        "Paraneoplastic syndrome",
        "Thyroid storm"
    ],
    "methods": null,
    "publication_date": "2022-07-12",
    "pubmed_id": "35813694\n22690898\n2079117\n18851873\n20673583\n33031755\n26981562\n9183570\n25343237\n23148158\n5100890\n7318191\n25315998\n28653031\n31693991",
    "results": null,
    "title": "Just an Acute Pulmonary Edema? Paraneoplastic Thyroid Storm Due to Invasive Mole.",
    "xml": "<Element 'PubmedArticle' at 0x788506f70b30>"
}