Production of parathyroid hormone by a malignant nonparathyroid tumor in a hypercalcemic patient.
Few cases exist in which the production and secretion of PTH by malignant nonparathyroid tumors have been authenticated. A 69-yr-old man developed hypercalcemia complicating a primitive neuroectodermal malignancy that was widely metastatic. The serum level of intact PTH was markedly increased by immunoradiometric assay (90-290 ng/L; normal, 10-65 ng/L). The serum level of a PTH-related protein was also increased (19-20 ngeq/L; normal, < 10 ngeq/L). Exploration of the neck and mediastinum at two operations revealed four normal parathyroid glands. Extracts of the metastatic tumor contained immunoreactive PTH and transcripts of both the PTH and PTH-related protein genes. Thus, hypercalcemia in this patient was associated with production of PTH by a nonparathyroid malignancy.
Strewler
G J
GJ
Endocrine Unit, Veterans Administration Medical Center, San Francisco, California 94121.
Budayr
A A
AA
Clark
O H
OH
Nissenson
R A
RA
D000368:Aged; D015870:Gene Expression; D015321:Gene Rearrangement; D006801:Humans; D006934:Hypercalcemia / Q000150:complications*; D007124:Immunoenzyme Techniques; D008297:Male; D010281:Parathyroid Hormone / Q000096:biosynthesis* / Q000235:genetics; D011061:Poly A / Q000378:metabolism; D012313:RNA / Q000378:metabolism; D012333:RNA, Messenger; D012878:Skin Neoplasms / Q000150:complications / Q000378:metabolism* / Q000556:secondary
D010281:Parathyroid Hormone; D012333:RNA, Messenger; D011061:Poly A; D012313:RNA