我们报告了一例62岁的肾细胞癌(RCC)妇女,表现为高钙血症引起的昏迷。实验室评估表明非甲状旁腺介导的高钙血症,初始血清钙水平为18.6mg/dL。我们的患者的甲状旁腺激素(PTH)相关肽水平检测不到。初始成像阴性,但PET扫描发现左肾上极有肿块.我们的病人接受了部分肾切除术,并在最终病理上将肿块鉴定为RCC。手术后,高钙血症消退,PTH恢复正常.此病例报告描述了患有RCC的患者,其异常表现为高钙血症性昏迷。我们回顾了恶性高钙血症的鉴别诊断和RCC发生的高钙血症的评估。这个案例说明需要仔细审查和解释所有可用的数据,特别是当高钙血症的常规检查未发现时。
We report a
case of a 62-year-old woman with renal cell carcinoma (RCC) presenting with a hypercalcemia-induced coma. A laboratory evaluation indicated nonparathyroid-mediated hypercalcemia with an initial serum calcium level of 18.6 mg/dL. Our patient\'s parathyroid hormone (PTH)-related peptide level was undetectable. Initial imaging was negative, but PET scan identified a mass in the upper pole of the left kidney. Our patient underwent partial nephrectomy, and the mass was identified as RCC on final pathology. After surgery, her hypercalcemia resolved and PTH returned to normal limits. This
case report describes a patient with RCC with the unusual presentation of hypercalcemic coma. We review the differential diagnosis of malignant hypercalcemia and the evaluation of hypercalcemia occurring with RCC. This
case illustrates the need to carefully review and interpret all available data, especially when conventional testing in the work-up of hypercalcemia is unrevealing.