HUMORAL HYPERCALCEMIA OF HEPATOCELLULAR CARCINOMA ASSOCIATED WITH ELEVATED LEVELS OF PARATHYROID-HORMONE-RELATED-PEPTIDE

1995 ◽  
Vol 1 (3) ◽  
pp. 166-169 ◽  
Author(s):  
K.K. Pun, MD ◽  
S.M. Tam, MD
Keyword(s):  
Hepatocellular Carcinoma ◽  
Parathyroid Hormone ◽  
Related Peptide ◽  
Humoral Hypercalcemia ◽  
Parathyroid Hormone Related Peptide

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 Richter’s Syndrome with Hypercalcemia Induced by Tumor-Associated Production of Parathyroid Hormone-Related Peptide

2017 ◽  
Vol 10 (1) ◽  
pp. 123-126 ◽  
Author(s):  
Naoki Watanabe ◽  
Hajime Yasuda ◽  
Soji Morishita ◽  
Yasuo Aota ◽  
Junichi Tomomatsu ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Lymphocytic Leukemia ◽  
Rt Pcr ◽  
Adult T Cell Leukemia ◽  
Related Peptide ◽  
Associated Production ◽  
Humoral Hypercalcemia ◽  
Pcr Method ◽  
Parathyroid Hormone Related Peptide ◽  
Richter’S Syndrome

Humoral hypercalcemia due to parathyroid hormone-related peptide (PTHrP) elevation is a well-known complication of various malignancies, but the situation is rare concerning hematological malignancies except for adult T-cell leukemia/lymphoma. We report a case of Richter’s syndrome with humoral hypercalcemia, and demonstrate by reverse transcription polymerase chain reaction (RT-PCR) that peripheral blood PTHrP levels were 2,500-fold higher compared to healthy controls. PTHrP production by tumor cells in chronic lymphocytic leukemia (CLL) and Richter’s syndrome has been previously demonstrated by nonquantitative methods such as immunohistochemistry and northern blot analysis, but this is the first report using the RT-PCR method. The presented case did not have hypercalcemia when initially diagnosed as small lymphocytic lymphoma (SLL), and as reported earlier, the development of hypercalcemia may be an indication of the transformation to Richter’s syndrome in patients with CLL/SLL.

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