医学
原发性甲状旁腺功能亢进
甲状旁腺激素
恶性肿瘤
内科学
甲状旁腺主细胞
甲状旁腺癌
病理
内分泌学
甲状旁腺肿瘤
癌症
相伴的
癌
钙
甲状旁腺腺瘤
作者
Koji Nakajima,Masataka Tamai,Shinji Okaniwa,Yoshiyuki Nakamura,Mutsuhiro Kobayashi,Tomohiro Niwa,Naoto Horigome,Nobuo Ito,Satoru Suzuki,Shintaro Nishio,Mitsuhisa Komatsu
出处
期刊:Endocrine Journal
[The Japan Endocrine Society]
日期:2013-01-01
卷期号:60 (5): 557-562
被引量:42
标识
DOI:10.1507/endocrj.ej12-0406
摘要
Hypercalcemia with concomitant elevation of serum parathyroid hormone (PTH) and PTH-related protein (PTHrP) levels was found in a patient with advanced gastric carcinoma and multiple liver metastases. The most common features are hypercalcemia associated with hypersecretion of PTHrP and physiological suppression of PTH secretion in the syndrome of humoral hypercalcemia of malignancy (HHM). Although we initially made a diagnosis of primary hyperparathyroidism concomitant with HHM due to gastric cancer, diagnostic imaging studies, such as echography, CT, sestamibi scintigraphy, and autopsy findings, did not reveal evidence of any parathyroid tumors or ectopic parathyroid glands in the mediastinum. Both primary and metastatic tumor cells showed positive staining with PTH-specific antibody as well as PTHrP-specific antibody on immunohistochemical examination. PTH concentration in the cytosolic fraction of the metastatic tumor was elevated compared to that from a control patient with no calcium metabolic disorders in vitro. These findings indicated that PTH secreted ectopically by gastric cancer cells, not by parathyroid glands, caused hypercalcemia in this patient. To our knowledge, this is the first case report of PTH-secreting gastric carcinoma cells. We report the case and a review of the previous reported PTH-secreting non-parathyroid tumors along with the mechanisms of secretion.
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