Adenosquamous carcinoma of the pancreas associated with humoral hypercalcemia of malignancy (HHM).
We report a rare case of adenosquamous carcinoma of the pancreas associated with humoral hypercalcemia of malignancy (HHM) in which parathyroid hormone-related protein (PTH-rP) was identified as the causative factor of hypercalcemia. A 72-year-old Japanese man was admitted to our institution complaining of fever and abdominal pain. Abdominal computed tomography demonstrated a large tumor in the body of the pancreas, with multiple liver metastases. Both serum calcium and PTH-rP levels were elevated. No accumulation was observed on bone scan with technetium-99. The patient died of pneumonia 3 months after admission. Autopsy demonstrated that the neoplasm in the pancreas showed an abrupt histological transition from adenocarcinoma to squamous cell carcinoma. PTH-rP was identified in the primary pancreatic tumor cells by immunohistochemical examination and a reverse-transcription polymerase chain reaction (RTPCR) method. We concluded that PTH-rP was the causative factor of the HHM, based on the laboratory data, immunohistochemical examination, and messenger RNA (mRNA) expression. This is a very rare report of adenosquamous cell carcinoma of the pancreas associated with HHM.
Kobayashi
Noritoshi
N
Department of Gastroenterology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Japan.
Higurashi
Takuma
T
Iida
Hiroshi
H
Mawatari
Hironori
H
Endo
Hiroki
H
Nozaki
Yuichi
Y
Tomimoto
Ayako
A
Yoneda
Kyoko
K
Akiyama
Tomoyuki
T
Fujita
Koji
K
Takahashi
Hirokazu
H
Yoneda
Masato
M
Inamori
Masahiko
M
Abe
Yasunobu
Y
Kirikoshi
Hiroyuki
H
Kubota
Kensuke
K
Saito
Satoru
S
Ueno
Norio
N
Nakajima
Atsushi
A
Yamanaka
Shoji
S
Inayama
Yoshiaki
Y
D000368:Aged; D018196:Carcinoma, Adenosquamous / Q000097:blood / Q000150:complications*; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology*; D008297:Male; D010190:Pancreatic Neoplasms / Q000097:blood / Q000150:complications*; D010257:Paraneoplastic Syndromes / Q000097:blood / Q000209:etiology; D044162:Parathyroid Hormone-Related Protein / Q000032:analysis
D044162:Parathyroid Hormone-Related Protein