Τίτλος:
Unusual Complication of a Pancreatic Neuroendocrine Tumor Presenting
with Malignant Hypercalcemia
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Context: Hypersecretion of PTHrP is a relatively common cause of
malignancy-related hypercalcemia but has only been described in a few
cases of neuroendocrine tumors (NET).
Objective: The aim of this case report is to describe the clinical
syndrome, complex therapeutic interventions, and unusual complications
caused by persistent PTHrP hypersecretion in a patient with a pancreatic
NET.
Case Illustration: A 58-yr-old male patient presented with nonspecific
abdominal pain and was found to have severe hypercalcemia secondary to a
well-differentiated NET of the pancreas associated with extensive liver
metastases. Elevated ionized calcium levels accompanied by low serum PTH
and remarkably elevated PTHrP concentrations were consistent with
PTHrP-related hypercalcemia that proved to be resistant to various
chemotherapeutic regimens and supportive therapy. Partial control of the
humoral syndrome was obtained only after the application of
cytoreductive interventions and the introduction of various molecular
targeted therapies. Due to persistent PTHrP action, bone disease emerged
in the form of brown tumors.
Discussion: The manifestation of paraneoplastic syndrome due to PTHrP
hypersecretion, despite its rareness in NET, should be considered in the
differential diagnosis of hypercalcemia in such tumors. Moreover, the
appearance of bone lesions in this setting may be in the context of
metabolic bone disease and could be misdiagnosed as bone metastases. (J
Clin Endocrinol Metab 97: E627-E631, 2012)
Συγγραφείς:
Kanakis, G.
Kaltsas, G.
Granberg, D.
Grimelius, L. and
Papaioannou, D.
Tsolakis, A. V.
Oberg, K.
Περιοδικό:
JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM
DOI:
10.1210/jc.2011-2592
