PDF(Pubmed)
Abstract：
UNASSIGNED: Lung adenocarcinoma with parathyroid hormone (PTH)-related hypercalcemia is uncommon.
UNASSIGNED: A 69-year-old man was admitted to our hospital due to anorexia and fatigue. Serum calcium (15.0 mg/dL) and carcinoembryonic antigen (361.7 ng/mL) were extremely high, and PTH-related protein (PTH-rP) also elevated (16.7 pmol/L). Systemic computed tomography revealed multiple enlarged lymph nodes and disseminated peritoneal nodules, with irregularly shaped nodules in the upper lobe in the left lung. Ultrasound-guided biopsy from the axillary lymph node revealed adenocarcinoma. Immunohistological staining showed the tumor cells to be positive for cytokeratin 7 and PTH-rP and negative for cytokeratin 20 and thyroid transcription factor-1. Although the primary origin remains undetermined despite detailed examinations, possible primary tumor was considered to be lung adenocarcinoma in the present case. The serum calcium level was reduced by denosumab, but the patient died 20 days after admission.
UNASSIGNED: The present case demonstrated the importance of considering oncological emergency, such as hypercalcemia and/or PTH-rP-producing hypercalcemia, in patients with adenocarcinoma.
UNASSIGNED: A 69-year-old man was admitted to our hospital due to anorexia and fatigue. Serum calcium (15.0 mg/dL) and carcinoembryonic antigen (361.7 ng/mL) were extremely high, and PTH-related protein (PTH-rP) also elevated (16.7 pmol/L). Systemic computed tomography revealed multiple enlarged lymph nodes and disseminated peritoneal nodules, with irregularly shaped nodules in the upper lobe in the left lung. Ultrasound-guided biopsy from the axillary lymph node revealed adenocarcinoma. Immunohistological staining showed the tumor cells to be positive for cytokeratin 7 and PTH-rP and negative for cytokeratin 20 and thyroid transcription factor-1. Although the primary origin remains undetermined despite detailed examinations, possible primary tumor was considered to be lung adenocarcinoma in the present case. The serum calcium level was reduced by denosumab, but the patient died 20 days after admission.
UNASSIGNED: The present case demonstrated the importance of considering oncological emergency, such as hypercalcemia and/or PTH-rP-producing hypercalcemia, in patients with adenocarcinoma.
摘要：
■肺腺癌伴甲状旁腺激素（PTH）相关性高钙血症并不常见。
■一名69岁男子因厌食症和疲劳入院。血清钙（15.0mg/dL）和癌胚抗原（361.7ng/mL）极高，PTH相关蛋白(PTH-rP)也升高(16.7pmol/L)。全身计算机断层扫描显示多个肿大的淋巴结和播散的腹膜结节，左肺上叶有不规则形状的结节。腋窝淋巴结超声引导活检显示腺癌。免疫组织学染色显示肿瘤细胞对细胞角蛋白7和PTH-rP呈阳性，而对细胞角蛋白20和甲状腺转录因子-1呈阴性。尽管经过详细检查，主要来源仍未确定，在本病例中，可能的原发肿瘤被认为是肺腺癌。Denosumab降低了血清钙水平，但患者在入院20天后死亡。
■本案证明了考虑肿瘤急诊的重要性，如高钙血症和/或产生PTH-rP的高钙血症，在腺癌患者中。
■一名69岁男子因厌食症和疲劳入院。血清钙（15.0mg/dL）和癌胚抗原（361.7ng/mL）极高，PTH相关蛋白(PTH-rP)也升高(16.7pmol/L)。全身计算机断层扫描显示多个肿大的淋巴结和播散的腹膜结节，左肺上叶有不规则形状的结节。腋窝淋巴结超声引导活检显示腺癌。免疫组织学染色显示肿瘤细胞对细胞角蛋白7和PTH-rP呈阳性，而对细胞角蛋白20和甲状腺转录因子-1呈阴性。尽管经过详细检查，主要来源仍未确定，在本病例中，可能的原发肿瘤被认为是肺腺癌。Denosumab降低了血清钙水平，但患者在入院20天后死亡。
■本案证明了考虑肿瘤急诊的重要性，如高钙血症和/或产生PTH-rP的高钙血症，在腺癌患者中。
