Hypercalcemia due to parathyroid hormone-related protein produced by primary ovarian clear cell adenocarcinoma: case report.
OBJECTIVE
Amongovarian carcinomas, clear cell adenocarcinoma is one of the most common histologic subtypes associated with hypercalcemia. However, the mechanisms of hypercalcemia in clear cell adenocarcinoma are still unclear. In the following case report, we tried to determine the etiology of hypercalcemia and also to demonstrate the management of hypercalcemia diagnosed preoperatively.


METHODS
A 49-year-old woman was diagnosed as having a malignant ovarian tumor with hypercalcemia caused by elevated serum parathyroid hormone-related protein (PTHrP) prior to her primary surgery. Treatment with disodium incadronate promptly normalized the serum calcium level. An immunohistochemical study demonstrated PTHrP expression in the primary ovarian lesion, but not in the metastatic lesion. A Northern blot analysis of the cancer cells from the ovarian tumor confirmed the presence of PTHrP mRNA.


CONCLUSIONS
Humoral hypercalcemia of malignancy in this case has been conclusively shown to be due to the production of PTHrP at the primary ovarian tumor, based on both immunohistochemical and molecular analyses.
Tsunematsu
R
R
Gynecology Service, Department of Biochemistry, Department of Pathology, National Kyushu Cancer Center, Notame 3-1-1, Minami-ku, Fukuoka, 811-1395, Japan.
Saito
T
T
Iguchi
H
H
Fukuda
T
T
Tsukamoto
N
N
D018262:Adenocarcinoma, Clear Cell / Q000150:complications* / Q000378:metabolism; D000328:Adult; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology*; D009363:Neoplasm Proteins / Q000378:metabolism*; D010051:Ovarian Neoplasms / Q000150:complications* / Q000378:metabolism; D044162:Parathyroid Hormone-Related Protein; D011506:Proteins / Q000378:metabolism*; D012333:RNA, Messenger / Q000378:metabolism
D009363:Neoplasm Proteins; C470121:PTHLH protein, human; D044162:Parathyroid Hormone-Related Protein; D011506:Proteins; D012333:RNA, Messenger