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.
Department of Gastroenterology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Japan.
Noritoshi
N
Kobayashi
Takuma
T
Higurashi
Hiroshi
H
Iida
Hironori
H
Mawatari
Hiroki
H
Endo
Yuichi
Y
Nozaki
Ayako
A
Tomimoto
Kyoko
K
Yoneda
Tomoyuki
T
Akiyama
Koji
K
Fujita
Hirokazu
H
Takahashi
Masato
M
Yoneda
Masahiko
M
Inamori
Yasunobu
Y
Abe
Hiroyuki
H
Kirikoshi
Kensuke
K
Kubota
Satoru
S
Saito
Norio
N
Ueno
Atsushi
A
Nakajima
Shoji
S
Yamanaka
Yoshiaki
Y
Inayama
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