title: Hypercalcemia mediated by parathyroid hormone-related protein as an early manifestation of pancreatic adenocarcinoma metastasis: a case report.
abstract: Humoral hypercalcemia of malignancy (HHM) is a paraneoplastic syndrome rarely associated with pancreatic adenocarcinoma. Parathyroid hormone-related peptide (PTHrP) is the central mediator of this condition. In our patient, hypercalcemia associated with elevated PTHrP was the initial manifestation of metastatic pancreatic adenocarcinoma. Successful palliation of HHM with bisphosphonates and loop diuretics has been previously reported and was effective in our patient. We report the first case of pancreatic adenocarcinoma metastasis after successful resection to present with hypercalcemia.
authors.affiliation: Department of Internal Medicine, Wilford Hall Medical Center, Lackland AFB, Texas 78236-5157, USA. mark.rasnake@59mdw.whmc.af.mil
authors.forename: M S
authors.initials: MS
authors.lastname: Rasnake
authors.forename: C
authors.initials: C
authors.lastname: Glanton
authors.forename: D
authors.initials: D
authors.lastname: Ornstein
authors.forename: M
authors.initials: M
authors.lastname: Osswald
authors.forename: M
authors.initials: M
authors.lastname: Garrison
mesh_terms: D000230:Adenocarcinoma / Q000097:blood* / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D003131:Combined Modality Therapy; D017809:Fatal Outcome; D006801:Humans; D006934:Hypercalcemia / Q000097:blood / Q000209:etiology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000097:blood*; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D010281:Parathyroid Hormone / Q000097:blood*; D044162:Parathyroid Hormone-Related Protein; D011506:Proteins / Q000378:metabolism*; D012186:Retroperitoneal Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000556:secondary*
chemical_list: D009363:Neoplasm Proteins; C470121:PTHLH protein, human; D010281:Parathyroid Hormone; D044162:Parathyroid Hormone-Related Protein; D011506:Proteins