Humoral hypercalcemia complicating adenocarcinoma of the sigmoid colon: report of a case.
Humoral hypercalcemia can arise from a variety of malignancies, but its association with primary colorectal carcinoma is rare, with only 20 such cases documented in the English-language literature to date. We report an additional case to clarify the clinicopathologic features of colorectal carcinoma with humoral hypercalcemia. A 54-year-old woman was admitted with symptomatic hypercalcemia of 14.2 mg/dl and multiple hepatic metastases, 2 years after resection of sigmoid colon cancer. The hypercalcemia was caused by the circulating parathyroid hormone-related peptide (PTHrP) produced by poorly differentiated adenocarcinoma in the liver. The PTHrP level on admission was 13.5 pmol/l. Despite systemic chemotherapy, the patient died of disease progression 3 weeks after the humoral hypercalcemia was diagnosed. A review of the 21 reported cases, including ours, suggests that colorectal carcinoma associated with humoral hypercalcemia is characterized by a poorly differentiated tumor with or without squamous or neuroendocrine features, distant metastases, and a dismal prognosis.
Sakata
Jun
J
Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata 951-8510, Japan.
Wakai
Toshifumi
T
Shirai
Yoshio
Y
Sakata
Eiko
E
Hasegawa
Go
G
Hatakeyama
Katsuyoshi
K
D000230:Adenocarcinoma / Q000097:blood / Q000150:complications*; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000097:blood / Q000209:etiology*; D008875:Middle Aged; D010257:Paraneoplastic Syndromes / Q000150:complications; D044162:Parathyroid Hormone-Related Protein / Q000097:blood; D012811:Sigmoid Neoplasms / Q000097:blood / Q000150:complications*
D044162:Parathyroid Hormone-Related Protein