title: Paraneoplastic hypercalcemia with adenosquamous carcinoma of the colon.
abstract: Hypercalcemia is a well-known manifestation of paraneoplastic syndromes associated with a variety of malignancies. However, colon cancer has only rarely been associated with hypercalcemia. Here we present the first case of adenosquamous carcinoma of the sigmoid colon in a patient who was found to have hypercalcemia associated with parathyroid hormone-related protein (PTHrP), with no radiological evidence of metastasis to other organs. A 78-year-old woman was admitted to our hospital complaining of lower abdominal pain. Physical examination and computed tomography revealed a tumor, 13 cm in diameter, in the sigmoid colon. Laboratory data showed an elevated serum calcium level (11.2 mg/dl). Primary colostomy was performed. After the primary operation, the patient was found to have hypercalcemia and an elevated PTHrP level. We performed sigmoidectomy, total hysterectomy, and partial urinary bladder resection 1 month after the primary operation, and both PTHrP and calcium levels immediately returned to normal. The histopathologic diagnosis was poorly differentiated adenosquamous carcinoma. The patient died due to tumor recurrence 4 months after the second surgery.
authors.affiliation: Department of Cancer and Thoracic Surgery, Okayama University Graduate School of Medicine and Dentistry, Okayama 700-8558, Japan. cqs03255@nifty.com
authors.forename: Takeo
authors.initials: T
authors.lastname: Fujita
authors.forename: Kazuma
authors.initials: K
authors.lastname: Fukuda
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Nishi
authors.forename: Tomoya
authors.initials: T
authors.lastname: Takao
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ohmura
authors.forename: Masayuki
authors.initials: M
authors.lastname: Mano
authors.forename: Syokichi
authors.initials: S
authors.lastname: Komatsubara
mesh_terms: D000368:Aged; D018196:Carcinoma, Adenosquamous / Q000150:complications* / Q000601:surgery; D003110:Colonic Neoplasms / Q000150:complications* / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology*; D010257:Paraneoplastic Syndromes / Q000209:etiology* / Q000473:pathology; D044162:Parathyroid Hormone-Related Protein / Q000097:blood
chemical_list: D044162:Parathyroid Hormone-Related Protein