二次性尿崩症をきたしたＰＴＨｒＰ産生肺癌の１例

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  • A Case of PTHrP-producing Lung Cancer Complicated With Secondary Diabetes Insipidus Due to Hypercalcemia.

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Background. Hypercalcemia is a common complication of lung cancer patients, especially in advanceddisease. Parathyroid hormone-related protein (PTHrP) is one of the tumor products that play an important rolefor the formation of this pathological condition. We report herein a case of PTHr P-producing lung cancer associatedwith secondary diabetes insipidus (DI) due to hypercalcemia. Case. A 67-year-old man was admitted in May, 1999 becauseof cough and abnormal shadow on chest X-ray. Advanced lung cancer in the left lower lobe was diagnosed and heunderwent 3 courses of chemotherapy consisting of cisplatin and docetaxel. A total of 52 Gy radiation therapy was administeredto the left hilum to improve the obstruction of the left main bronchus invaded by the tumor 8 months later.He was readmitted in November, 2000 because of progression of the disease. Chest CT scan showed regrowth of the tumorand complete atelectasis of the left lung. Polydipsia and 3, 000-5, 000ml/day polyuria were present during hospitalization.There was no evidence of bone or brain metastasis. Hypercalcemia and high serum levels of C-terminal PTHr Pwere observed, which strongly suggested secondary DI due to humoral hypercalcemia of malignancy (HHM). Pamidronatedisodium was administered of a dose of 30mg, and the hypercalcemia improved immediately. He died due to respiratoryfailure caused by multiple lung metastasis a month later. We examined the expression of the PTHrP antigen immunohistochemicallyin the section from the autopsy specimen. Immunoreactivity was measured in the cytoplasm ofthe tumor cells. Conclusion. We encountered a case of PTHr P-producing lung cancer associated with secondary DI.Treatment with pamidronate disodium alone was effective for HHM in this patient with cardiopulmonary hypofunction.

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  • 肺癌

    肺癌 42 (3), 209-213, 2002

    特定非営利活動法人 日本肺癌学会

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