A Case of Leiomyosarcoma Associated with Humoral Hypercalcemia of Malignancy: Demonstration of Biological and Immunological Activities of Parathyroid Hormone-related Protein in the Tumor Extract |
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| Authors: | Naokazu Nagata Jyun Takeda Nobuo Kugai Hiroyuki Kimoto Souichi Tomimatsu Osamu Takatani Kazuo Suzuki Yusuke Fuse Takayuki Tsuchihashi Ken Yamaguchi Kaoru Abe |
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| Affiliation: | The Third Department of Internal Medicine;the Second Department of Pathology, National Defense Medical College, 3–2, Namiki, Tokorozawa-shi, Saitama 359;the Growth Factor Division, National Cancer Center Research Institute, 5–1-1, Tsukiji, Chuo-ku, Tokyo 104 |
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| Abstract: | Hypercalcemia occurred in a patient with leiomyosarcoma when multiple lung metastases developed. Despite normal plasma parathyroid hormone (PTH) levels and low 1,25-dihydroxyvitamin D, this hypercalcemic patient had a marked hypercakiuria and phosphatnria associated with an increased excretion of nephrogenous cyclic AMP (NcAMP). Administration of cisplatin ameliorated both the hypercalcemia and hypercalciuria without any reduction in tumor size or NcAMP excretion. Terminally, acute pancreatitis occurred producing a profound hypocalcemia. In the extract of tumor tissue obtained post mortem, bioactivity stimulating the generation of cyclic AMP in osteogenic cells was demonstrated along with the immunoreactive PTH-related protein (PTH-rP). This is the first report of a solid non-epithelial malignancy producing PTH-rP and associated with humoral hypercalcemia of malignancy. The hypercalcemia in this case caused acute pancreatitis, which led to a profound hypocalcemia |
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| Keywords: | Leiomyosarcoma Humoral hypercalcemia of malignancy Parathyroid hormone-related protein Cisplatin Acute pancreatitis |
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