Humoral hypercalcemia associated with gastric carcinoma secreting parathyroid hormone: a case report and review of the literature

• Nakajima Koji

  Department of Internal Medicine, Iida Municipal Hospital, Iida 395-8502, Japan

• Tamai Masataka

  Department of Internal Medicine, Iida Municipal Hospital, Iida 395-8502, Japan

• Okaniwa Shinji

  Department of Internal Medicine, Iida Municipal Hospital, Iida 395-8502, Japan

• Nakamura Yoshiyuki

  Department of Internal Medicine, Iida Municipal Hospital, Iida 395-8502, Japan

• Kobayashi Mutsuhiro

  Department of Internal Medicine, Iida Municipal Hospital, Iida 395-8502, Japan

• Niwa Tomohiro

  Department of Internal Medicine, Iida Municipal Hospital, Iida 395-8502, Japan

• Horigome Naoto

  Department of Surgery, Iida Municipal Hospital, Iida 395-8502, Japan

• Ito Nobuo

  Department of Clinical Pathology, Iida Municipal Hospital, Iida 395-8502, Japan

• Suzuki Satoru

  Department of Aging and Geriatrics, Shinshu University School of Medicine, Matsumoto 390-8621, Japan

• Nishio Shinichi

  Department of Aging and Geriatrics, Shinshu University School of Medicine, Matsumoto 390-8621, Japan

• Komatsu Mitsuhisa

  Department of Aging and Geriatrics, Shinshu University School of Medicine, Matsumoto 390-8621, Japan

抄録

Hypercalcemia with concomitant elevation of serum parathyroid hormone (PTH) and PTH-related protein (PTHrP) levels was found in a patient with advanced gastric carcinoma and multiple liver metastases. The most common features are hypercalcemia associated with hypersecretion of PTHrP and physiological suppression of PTH secretion in the syndrome of humoral hypercalcemia of malignancy (HHM). Although we initially made a diagnosis of primary hyperparathyroidism concomitant with HHM due to gastric cancer, diagnostic imaging studies, such as echography, CT, sestamibi scintigraphy, and autopsy findings, did not reveal evidence of any parathyroid tumors or ectopic parathyroid glands in the mediastinum. Both primary and metastatic tumor cells showed positive staining with PTH-specific antibody as well as PTHrP-specific antibody on immunohistochemical examination. PTH concentration in the cytosolic fraction of the metastatic tumor was elevated compared to that from a control patient with no calcium metabolic disorders in vitro. These findings indicated that PTH secreted ectopically by gastric cancer cells, not by parathyroid glands, caused hypercalcemia in this patient. To our knowledge, this is the first case report of PTH-secreting gastric carcinoma cells. We report the case and a review of the previous reported PTH-secreting non-parathyroid tumors along with the mechanisms of secretion.

収録刊行物

• Endocrine Journal

  Endocrine Journal 60 (5), 557-562, 2013

  一般社団法人 日本内分泌学会

キーワード

• Humoral hypercalcemia of malignancy (HHM)
• Parathyroid hormone
• Gastric carcinoma
• Immunohistochemistry
• Cytosolic fraction

詳細情報

• CRID: 1390282681276138496
• NII論文ID: 10031184522
• NII書誌ID: AA10901436
• DOI: 10.1507/endocrj.ej12-0406
• COI: 1:STN:280:DC%2BC3s3otFKqtQ%3D%3D
• ISSN: 13484540
• ISSN: 09188959
• PubMed: 23303131
• Web Site: https://www.jstage.jst.go.jp/article/endocrj/60/5/60_EJ12-0406/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2014196796
• 本文言語コード: en
• データソース種別:
  • JaLC
  • Crossref
  • PubMed
  • CiNii Articles
  • KAKEN
• 抄録ライセンスフラグ: 使用不可