Humoral hypercalcemia of benignancy secondary to parathyroid hormone-related protein secreting uterine leiomyoma.
A 48-year-old women admitted with polyuria and polydipsia. She was found to be hypercalcemic despite suppressed parathormone (iPTH) levels. Subsequently checked parathormone related-protein (PTHrP) level was 2.5 pmol/L (expected normal level <1.3 pmol/L). An extensive workup for a malignancy revealed no abnormality, except for an uterine leiomyoma, 7.1 cm in size. Total abdominal hysterectomy and salpingo-oophorectomy were performed. After the surgical removal of uterine leiomyoma, serum calcium (9.3 mg/dL), iPTH (29.4 pg/mL), and PTHrP (<1.3 pmol/L) levels were normalized. The diagnosis of humoral hypercalcemia of benignancy secondary to PTHrP was confirmed. One month later, her calcium and iPTH levels were normal and 1 year later still remain within the normal ranges. Our case indicates that PTHrP associated hypercalcemia does not solely result from a malignant tumor. Benign tumors like uterine leiomyoma might also cause humoral hypercalcemia.
Dagdelen
Selcuk
S
Department of Endocrinology and Metabolism, Hacettepe University School of Medicine, Ankara, Turkey. dagdelen@hacettepe.edu.tr
Kalan
Isilay
I
Gurlek
Alper
A
D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology*; D007889:Leiomyoma / Q000150:complications* / Q000378:metabolism; D008875:Middle Aged; D044162:Parathyroid Hormone-Related Protein / Q000378:metabolism*; D014594:Uterine Neoplasms / Q000150:complications* / Q000378:metabolism
D044162:Parathyroid Hormone-Related Protein