title: Humoral hypercalcemia in patients with colorectal carcinoma: report of two cases and review of the literature.
abstract: BACKGROUND
  Humoral hypercalcemia rarely is associated with colorectal carcinoma; to the authors' knowledge only nine cases have been reported to date.
  
  
  METHODS
  Two cases of advanced colorectal carcinoma with humoral hypercalcemia of malignancy (HHM) are presented.
  
  
  RESULTS
  The two patients had severe hypercalcemia without bone metastases. The diagnosis of HHM was based on findings of hypercalcemia, hypophosphoremia, elevated serum parathyroid hormone-related peptide (PTHrP), and positive tumor immunoreactivity to monoclonal PTHrP antiserum. One patient had a colonic adenocarcinoma with a neuroendocrine component and the other patient had rectal adenocarcinoma. Immunoreactive PTHrP was found in both tumor components. Bisphosphonate treatment normalized the hypercalcemia within a few days but it recurred in the patients 2 weeks and 3 weeks later, respectively. The prognosis was extremely poor.
  
  
  CONCLUSIONS
  To the authors' knowledge the two cases presented in the current study are the first to be reported with HHM-associated colorectal carcinoma with positive tumor immunoreactivity to PTHrP monoclonal antiserum.
authors.affiliation: Department of Medical Oncology, Centre Paul Papin, Angers, France.
authors.forename: A H
authors.initials: AH
authors.lastname: Lortholary
authors.forename: S D
authors.initials: SD
authors.lastname: Cadeau
authors.forename: G M
authors.initials: GM
authors.lastname: Bertrand
authors.forename: V I
authors.initials: VI
authors.lastname: Guerin-Meyer
authors.forename: E C
authors.initials: EC
authors.lastname: Gamelin
authors.forename: M J
authors.initials: MJ
authors.lastname: Audran
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000473:pathology; D000911:Antibodies, Monoclonal; D003110:Colonic Neoplasms / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D044162:Parathyroid Hormone-Related Protein; D011506:Proteins / Q000032:analysis / Q000276:immunology; D012004:Rectal Neoplasms / Q000150:complications* / Q000473:pathology
chemical_list: D000911:Antibodies, Monoclonal; C470121:PTHLH protein, human; D044162:Parathyroid Hormone-Related Protein; D011506:Proteins