title: Undifferentiated pancreatic cancer associated with humoral hypercalcemia of malignancy.
abstract: We present a case of undifferentiated pancreatic cancer associated with humoral hypercalcemia of malignancy (HHM) in which parathyroid hormone-related protein (PTH-rP) is identified as the causative factor of hypercalcemia. A 61-year-old man was hospitalized with right hypochondralgia. Ultrasound examination and computed tomography demonstrated a large mass in the pancreatic head with liver metastases. Biopsy of the pancreatic tumor demonstrated undifferentiated carcinoma. Serum calcium level and PTH-rP were elevated. Bone scan with technetium-99 demonstrated no accumulation in the bones. Immunohistochemical staining for PTH-rP was weakly positive in the tumor cells. We considered that PTH-rP was the causative factor of HHM in this case from laboratory data and immunohistochemical findings. This rare case was successfully treated with pamidronate disodium, which is a type of bisphosphonate derivative. We compared this case with previously reported cases.
authors.affiliation: Department of Internal medicine, Saiseikai Maebashi Hospital, Japan. kakizaki@news.sb.gunma-u.ac.jp
authors.forename: S
authors.initials: S
authors.lastname: Kakizaki
authors.forename: N
authors.initials: N
authors.lastname: Ohya
authors.forename: T
authors.initials: T
authors.lastname: Yoshinaga
authors.forename: T
authors.initials: T
authors.lastname: Higuchi
authors.forename: R
authors.initials: R
authors.lastname: Kitazawa
authors.forename: H
authors.initials: H
authors.lastname: Takayama
authors.forename: H
authors.initials: H
authors.lastname: Takagi
authors.forename: T
authors.initials: T
authors.lastname: Nagamine
authors.forename: M
authors.initials: M
authors.lastname: Mori
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D002277:Carcinoma / Q000150:complications* / Q000188:drug therapy / Q000556:secondary; D004164:Diphosphonates / Q000627:therapeutic use; D006801:Humans; D006934:Hypercalcemia / Q000150:complications*; D008113:Liver Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D000077268:Pamidronate; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D044162:Parathyroid Hormone-Related Protein; D011506:Proteins / Q000032:analysis / Q000502:physiology
chemical_list: D000970:Antineoplastic Agents; D004164:Diphosphonates; C470121:PTHLH protein, human; D044162:Parathyroid Hormone-Related Protein; D011506:Proteins; D000077268:Pamidronate