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

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

[1]  C. Blomqvist,et al.  Malignant hypercalcemia--a hospital survey. , 2009, Acta medica Scandinavica.

[2]  K. Shimotohno,et al.  PRODUCTION OF PARATHYROID HORMONE‐RELATED PROTEIN IN ADULT T‐CELL LEUKEMIA CELLS , 1988, Japanese journal of cancer research : Gann.

[3]  A. F. Stewart,et al.  Humoral Hypercalcemia of Cancer , 1988 .

[4]  T. Watanabe,et al.  Expression of parathyroid hormone-related protein in a human T cell lymphotrophic virus type I-infected T cell line. , 1988, Biochemical and biophysical research communications.

[5]  A. Broadus,et al.  Humoral hypercalcemia of malignancy in canine lymphosarcoma. , 1988, Endocrinology.

[6]  S. Kukreja,et al.  Treatment of cancer-associated hypercalcemia with cisplatin. , 1987, Archives of internal medicine.

[7]  B. Chernow,et al.  Hypocalcemia in critical illness. , 1986, JAMA.

[8]  T. Shimauchi,et al.  Enhancement of cyclic adenosine monophosphate content in bone cells by the factor extracted from a pancreatic cancer associated with hypercalcemia. , 1986, Metabolism: clinical and experimental.

[9]  A. F. Stewart,et al.  Two species of adenylate cyclase-stimulating activity in a murine squamous carcinoma model of humoral hypercalcemia of malignancy. , 1986, Endocrinology.

[10]  C. Patte,et al.  Hypercalcemia preferentially occurs in unusual forms of childhood non‐hodgkin's lymphoma, rhabdomyosarcoma, and Wilms' tumor. A study of 11 cases , 1984, Cancer.

[11]  R. Selander,et al.  Hypercalcemia and elevated serum parathyroid hormone level in association with rhabdomyosarcoma. , 1984, Archives of pathology & laboratory medicine.

[12]  T. Takeuchi,et al.  Rhabdomyosarcoma‐induced hypercalcemia in a nude mouse , 1982, Cancer.

[13]  R. Hutchinson,et al.  Elevated parathyroid hormone levels in association with rhabdomyosarcoma. , 1978, The Journal of pediatrics.

[14]  O. Clark.  Pancreatitis, hypercalcemia, and breast carcinoma. , 1976, JAMA.

[15]  R. Levy,et al.  Thyrotoxicosis Associated with Renal Tubular Acidosis and Acute Pancreatitis: A Case Report , 1976 .

[16]  E. W. Moore,et al.  Inadequate parathyroid response in acute pancreatitis. , 1976, The New England journal of medicine.

[17]  E. Hochgelerent,et al.  Acute pancreatitis secondary to calcium infusion in a dialysis patient. , 1974, Archives of surgery.

[18]  R. R. Manson.  Acute pancreatitis secondary to iatrogenic hypercalcemia: implications of hyperalimentation. , 1974, Archives of surgery.

[19]  Eisenberg,et al.  Interpretation of Serum Calcium in Patients with Abnormal Serum Proteins , 1973, British medical journal.

[20]  P. Fourman,et al.  ACUTE PANCREATITIS FROM VITAMIN-D POISONING IN A PATIENT WITH PARATHYROID DEFICIENCY , 1966 .

[21]  C. Hawker,et al.  Actinomycin D and the Response to Parathyroid Hormone , 1964, Science.

[22]  R. Custer,et al.  Acute pancreatitis secondary to hypercalcemia of multiple myeloma. , 1962, Annals of internal medicine.

[23]  E. May,et al.  [Hypercalcemia and breast carcinoma]. , 1962, Medizinische Klinik.

[24]  A. F. Stewart,et al.  Nephrogenous cyclic AMP, adenylate cyclase-stimulating activity, and the humoral hypercalcemia of malignancy. , 1986, Recent progress in hormone research.

[25]  T. Powles,et al.  Mithramycin therapy : an adjunct to conventional treatment of hypercalcaemia and bone metastases in breast cancer , 1980 .