title: Hypercalcemia due to ectopic secretion of parathyroid related protein from pancreatic carcinoma: a case report.
abstract: This case is a report of a male, 52 year old, heavy smoker, with a history of about 10 years of alcohol abuse (he quitted in 1993), gastric resection for ulcer (Billroth II 1970), hypoparathyroidism and macroamylasemia, died for undiagnosed pancreatic carcinoma revealed at necroscopy. The only clinical evidence of carcinoma were pulmonary metastasis and paraneoplastic syndrome characterized from hyponatriemia due to inappropriate secretion of antidiuretic hormone and elevation of seric calcium caused by parathyroid hormone related protein. In patients without endocrine abnormalities, such unusual paraneoplastic syndrome could cause hypercalcemia, but in our patient, the increased calcemia did not reach abnormal levels due to the previous hypoparathyroidism. At present time, there are no clinical reports of parathyroid related protein secretion by pancreatic carcinoma and therefore, it could speculate that this modification together with ectopic secretion of antidiuretic hormone, represent a peculiar evidence of otherwise unknown and undetectable pancreatic carcinoma.
authors.affiliation: Dept. of Clinical Science, Chair of Gastroenterology, University of Parma, Parma. giuliamartina@yahoo.it
authors.forename: Giulia Martina
authors.initials: GM
authors.lastname: Cavestro
authors.forename: Nicola
authors.initials: N
authors.lastname: Mantovani
authors.forename: Paolo
authors.initials: P
authors.lastname: Coruzzi
authors.forename: Antonio
authors.initials: A
authors.lastname: Nouvenne
authors.forename: Federico
authors.initials: F
authors.lastname: Marcucci
authors.forename: Angelo
authors.initials: A
authors.lastname: Franzè
authors.forename: Francesco
authors.initials: F
authors.lastname: Di Mario
authors.forename: Lajos
authors.initials: L
authors.lastname: Okolicsanyi
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism* / Q000556:secondary; D000437:Alcoholism / Q000150:complications; D017809:Fatal Outcome; D005221:Fatigue / Q000209:etiology; D006729:Hormones, Ectopic / Q000378:metabolism*; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology*; D006996:Hypocalcemia / Q000209:etiology; D007011:Hypoparathyroidism / Q000209:etiology; D007177:Inappropriate ADH Syndrome / Q000209:etiology; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000378:metabolism*; D009384:Paraneoplastic Endocrine Syndromes / Q000209:etiology*; D044162:Parathyroid Hormone-Related Protein; D011506:Proteins / Q000378:metabolism*
chemical_list: D006729:Hormones, Ectopic; C470121:PTHLH protein, human; D044162:Parathyroid Hormone-Related Protein; D011506:Proteins