scholarly journals Humoral Hypercalcemia of Malignancy with a Parathyroid Hormone-Related Peptide-Secreting Intrahepatic Cholangiocarcinoma Accompanied by a Gastric Cancer

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Katsushi Takeda ◽  
Ryosuke Kimura ◽  
Nobuhiro Nishigaki ◽  
Shinya Sato ◽  
Asami Okamoto ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Parathyroid Hormone ◽  
Intrahepatic Cholangiocarcinoma ◽  
Immunohistochemical Staining ◽  
Elevated Serum ◽  
Humoral Hypercalcemia Of Malignancy ◽  
Hypercalcemia Of Malignancy ◽  
Related Peptide ◽  
Humoral Hypercalcemia ◽  
Parathyroid Hormone Related Peptide

Humoral hypercalcemia of malignancy (HHM) is caused by the oversecretion of parathyroid hormone-related peptide (PTHrP) from malignant tumors. Although any tumor may cause HHM, that induced by intrahepatic cholangiocarcinoma (ICC) or gastric cancer (GC) is rare. We report here a 74-year-old male who displayed HHM with both ICC and GC and showed an elevated serum PTHrP level. Treatment of the hypercalcemia with saline, furosemide, elcatonin, and zoledronic acid corrected his serum calcium level and improved symptoms. Because treatment of ICC should precede that of GC, we chose chemotherapy with cisplatin (CDDP) and gemcitabine (GEM). Chemotherapy reduced the size of the ICC and decreased the serum PTHrP level. One year after diagnosis, the patient was alive in the face of a poor prognosis for an ICC that produced PTHrP. Immunohistochemical staining for PTHrP was positive for the ICC and negative for the GC, leading us to believe that the cause of the HHM was a PTHrP-secreting ICC. In conclusion, immunohistochemical staining for PTHrP may be useful in discovering the cause of HHM in the case of two cancers accompanied by an elevated serum PHTrP level. Chemotherapy with CDDP and GEM may be the most appropriate treatment for a PTHrP-secreting ICC.

scholarly journals Squamous Cell Carcinoma (Marjolin’s Ulcer) Arising in a Sacral Decubitus Ulcer Resulting in Humoral Hypercalcemia of Malignancy

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
John T. O’Malley ◽  
Candace Schoppe ◽  
Sameera Husain ◽  
Marc E. Grossman
Keyword(s):  
Squamous Cell Carcinoma ◽  
Parathyroid Hormone ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Decubitus Ulcer ◽  
Humoral Hypercalcemia Of Malignancy ◽  
Hypercalcemia Of Malignancy ◽  
Humoral Hypercalcemia ◽  
Marjolin’S Ulcer ◽  
Parathyroid Hormone Related Peptide

Long-standing burns, fissures, and ulcers that undergo malignant transformation into a variety of malignancies, including squamous cell carcinoma, is commonly referred to as a Marjolin’s ulcer. It is well recognized that squamous cell carcinomas of the lung and esophagus can cause humoral hypercalcemia of malignancy secondary to paraneoplastic secretion of parathyroid hormone-related peptide. However, it is extremely rare for a squamous cell carcinoma developing in a sacral decubitus ulcer to cause humoral hypercalcemia of malignancy. We describe the first case of a patient found to have elevated serum levels of parathyroid hormone related peptide related to his Marjolin’s ulcer. A 45-year-old African American man with T6 paraplegia and a sacral decubitus ulcer present for 20 years was admitted for hypercalcemia of unclear etiology. He was subsequently found to have elevated parathyroid hormone related peptide and an excisional biopsy from the ulcer showed invasive squamous cell carcinoma suggestive of humoral hypercalcemia of malignancy. The patient ultimately succumbed to sepsis while receiving chemotherapy for his metastatic squamous cell carcinoma. Humoral hypercalcemia of malignancy is a rare and likely underrecognized complication that can occur in a Marjolin’s ulcer.

Defining the roles of parathyroid hormone-related protein in normal physiology

1996 ◽  
Vol 76 (1) ◽  
pp. 127-173 ◽  
Author(s):  
W. M. Philbrick ◽  
J. J. Wysolmerski ◽  
S. Galbraith ◽  
E. Holt ◽  
J. J. Orloff ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Fetal Life ◽  
Related Protein ◽  
Humoral Hypercalcemia Of Malignancy ◽  
Physiological Functions ◽  
Hypercalcemia Of Malignancy ◽  
Normal Tissues ◽  
Humoral Hypercalcemia ◽  
Parathyroid Hormone Related Protein ◽  
Differentiation And Proliferation

Parathyroid hormone-related protein (PTHrP) was discovered as a result of a search for the circulating factor secreted by cancers which causes the common paraneoplastic syndrome humoral hypercalcemia of malignancy. Since the identification of the peptide in 1982 and the cloning of the cDNA in 1987, it has become clear that PTHrP is a prohormone that is posttranslationally cleaved by prohormone convertases to yield a complex family of peptides, each of which is believed to have its own receptor. It is also clear that the PTHrP gene is expressed not only in cancers but also in the vast majority of normal tissues during adult and/or fetal life. In contrast to the situation in humoral hypercalcemia of malignancy in which PTHrP plays the role of a classical "endocrine" hormone, under normal circumstances PTHrP plays predominantly paracrine and/or autocrine roles. These apparent physiological functions are also complex and appear to include 1) regulation of smooth muscle (vascular, intestinal, uterine, bladder) tone, 2) regulation of transepithelial (renal, placental, oviduct, mammary gland) calcium transport, and 3) regulation of tissue and organ development, differentiation, and proliferation. In this review, the discovery of PTHrP, the structure of its gene and its cDNAs, and the posttranslational processing of the initial translation products are briefly reviewed. Attention is then focused on a detailed organ system-oriented review of the normal physiological functions of PTHrP.

Parathyroid hormone-related peptide, measured by a midmolecule radioimmunoassay, in various hypercalcaemic and normocalcaemic conditions

1992 ◽  
Vol 127 (4) ◽  
pp. 294-300 ◽  
Author(s):  
Elisabet Bucht ◽  
Anders Eklund ◽  
Göran Toss ◽  
Rolf Lewensohn ◽  
Barbro Granberg ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Elevated Serum ◽  
Skeletal Metastases ◽  
Endocrine Diseases ◽  
Related Peptide ◽  
Silica Cartridge ◽  
The Subject ◽  
Parathyroid Hormone Related Peptide ◽  
Made In

The diagnosis of humoral hypercalcaemia of malignancy often presents considerable clinical problems. We have studied parathyroid hormone-related peptide (PTHrP) in serum from patients with humoral hypercalcaemia of malignancy (N=22), hypercalcaemia of malignancy with skeletal metastases(1 7), histologically confirmed primary hyperparathyroidism (21) and hypercalcaemic patients with various benign diseases (9). PTHrP measurements were also made in normocalcaemic patients with various malignancies (23), endocrine diseases (13), sarcoidosis (22) and chronic renal failure (17). PTHrP was measured by a novel radioimmunoassay using rabbit antibodies directed towards the midregion of the molecule. Immuno- or silica cartridge extraction of serum before radioimmunoassay enabled us to measure PTHrP in all samples, which may add further information about circulating forms of PTHrP. PTHrP was clearly elevated in patients with humoral hypercalcaemia of malignancy (5.0±4.7 pmol/l) (mean±sd, N=12) and when the kidney function was impaired (4.0±0.9 pmol/l) (N=15) (silica cartridge extraction), whether the subject was hyperalcaemic or not. Some patients with endocrine diseases, including two with primary hyperparathyroidism, had slightly elevated serum PTHrP concentrations, while they were normal in sarcoidosis. In healthy subjects the levels were 1.1±0.5 pmol/1 (N= 15) after immunoextraction and 0.8±0.2 pmol/l(N= 33) after silica cartridge extraction.

Sign in / Sign up

Export Citation Format

Share Document